Determinantes de la Mortalidad Hospitalaria en Pacientes con Cáncer tras el Alta de la Unidad de Cuidados Intensivos
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4812Palabras clave:
Unidades de Cuidados Intensivos, Mortalidad Hospitalaria, Neoplasias/mortalidad.Resumen
Introducción: Un número importante de pacientes con cáncer fallece tras el alta de la unidad de cuidados intensivos (UCI). Sin embargo, los factores asociados con la mortalidad son poco conocidos en la literatura. Objetivo: Investigar los factores determinantes e identificar la frecuencia de mortalidad intrahospitalaria en pacientes con cáncer después del alta de la UCI a planta. Método: Estudio de cohorte retrospectivo que incluyó pacientes con cáncer dados de alta de la UCI del Hospital del Cáncer I del Instituto Nacional del Cáncer entre el 1 de enero de 2018 y el 28 de diciembre de 2020. Se evaluó la asociación entre variables de exposición (clínicas y sociodemográficas) y los resultados (muerte) mediante regresión logística cruda y ajustada. Resultados: Se incluyeron 111 pacientes oncológicos sobrevivientes de la UCI. La mortalidad intrahospitalaria fue del 31,5% y la estancia media tras el alta de la UCI fue de 22,1 días (±24,44). El análisis múltiple reveló que los pacientes con puntuaciones finales más bajas en la Escala de Movilidad en UCI (IMS) al momento del alta de la UCI (OR 0,7; IC 95%, 0,52-0,93; p = 0,01), la presencia de metástasis en el momento del ingreso a la UCI (OR 2,89; IC 95%, 1,01-8,29; p = 0,04) y la hospitalización por motivos clínicos (OR 5,1; IC 95%, 1,7-15,8; p < 0,01) se asociaron con la mortalidad hospitalaria. Conclusión: La presencia de metástasis al ingreso en UCI, la hospitalización por motivos clínicos y la peor movilidad al alta están relacionadas con la mortalidad hospitalaria.
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