Parámetros fisiológicos y morbilidad materna grave en la pielonefritis aguda
DOI:
https://doi.org/10.24220/2318-0897v33a2025e8008Palabras clave:
Intensive care units, Maternal health, Near miss, healthcare, Pregnancy complications, Pyelonephritis., Vital signsResumen
Meta
Evaluar parámetros vitales relacionados con la morbilidad materna severa por pielonefritis aguda, como estrategia para mejorar la atención obstétrica.
Métodos
Estudio transversal y retrospectivo de casos hospitalarios de pielonefritis aguda destinados a mejoría en planta o ingreso a Unidad de Cuidados Intensivos (UCI), desde enero de 2014 hasta diciembre de 2018. Se compararon datos vitales de los casos utilizando medias y parámetros preestablecidos. como alteración de los sistemas de alerta descritos en la literatura, con significación estadística cuando p<0,05. Se calcularon las razones de probabilidad (OR) y los respectivos intervalos de confianza del 95 % (IC del 95 %) para examinar el efecto de las variables en el ingreso a la UCI.
Resultados
Se estudiaron un total de 335 casos, sin registro de muertes y 5,9% (n=20) de ingreso en UCI; éstos eran más jóvenes (22,0 ±4,8 vs. 24,6 ±5,3 años; p=0,022) y más frecuentemente primigrávidos (55% vs. 9,8%; p<0,001). La frecuencia cardíaca (FC), la saturación periférica de oxígeno (SpO2) y la frecuencia respiratoria (RR) mostraron diferencia significativa bajo las medias entre los grupos; clasificados como alterados, fueron los parámetros más prevalentes en el grupo de UCI. Hubo mayor asociación entre ingreso en UCI y FC ≥100lpm (OR=30,5, IC 95% 8,6-108,1), presión arterial diastólica (PAD) <50mmHg (OR=16,4, IC 95% 5, 3-50,0) y RR ≥ 22mpm (OR=13,4, IC 95% 4,8–37,3). Los casos con intervenciones críticas en UTI representaron 65% (n=13) ventilación mecánica, 40% (n=08) uso de vasopresores y 25% (n=05) hemoterapia.
Conclusión
Los cambios en FC, FR y SpO2 se presentaron con mayor frecuencia en los casos con ingreso a UCI y los criterios de FC≥100lpm, PAD<50mmHg y FR≥22mrpm mostraron mayor asociación con este desenlace.
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