| Popis: |
Hyperchloremia has been associated with a greater presence of morbidity and mortality, mainly described in critically ill patients, this may be relative and absolute, which could be reflected in the sodium-chloride difference.The primary objective was to determine whether the sodium-chloride difference31 mEq/L measured 24-48 hours after admission is a predictor of 28-day mortality in patients with COVID-19, and as secondary objectives to identify whether it is associated with higher requirement for invasive mechanical ventilation, presence of acute kidney injury and longer hospital stay.Retrospective, descriptive and analytical longitudinal cohort study, was done including all consecutive patients older than 16 years of any gender, admitted to the UMAE from March 1, 2020 to March 2021, which present a diagnosis of COVID-19 with RT-PCR test for SARS-CoV-2 positive.A total of 722 patients were included, the difference sodium-chloride31 mEq/L is not associated with an increased risk of death at 28 days (p = 1.172, OR: 1.35; 95%CI, 0.87-2.08) or requirement of mechanical ventilation (p = 0.47, OR: 1.19; 95%CI, 0.76-1.86), but is associated with a higher risk of AKI (p0.05, OR: 2.04; 95%CI, 1.33- 3.14) and longer hospital stay (p0.05).the sodium-chloride difference31 mEq/L in the first hours of admission is associated with a higher risk of presenting acute kidney injury during hospital stay in patients with COVID-19, as well as a longer hospital stay.la hipercloremia se ha asociado a mayor presencia de morbimortalidad principalmente en pacientes críticos, pudiendo esta ser relativa y absoluta, la cual se puede reflejar por medio de la diferencia sodio menos cloro.el objetivo primario fue determinar si la diferencia sodio menos cloro31 mEq/L medida a las 24-48 horas de ingreso es predictor de mortalidad a 28 días en pacientes con COVID-19, y como objetivos secundarios identificar si se asocia a mayor requerimiento de ventilación mecánica invasiva, presencia de lesión renal aguda y mayor estancia hospitalaria.estudio de tipo cohorte longitudinal retrospectivo, descriptivo y analítico, se incluyeron todos los pacientes blanco de manera consecutiva mayores de 16 años de cualquier género, ingresados en la UMAE No. 1 del Bajío de marzo del 2020 a marzo 2021, los cuales presentan diagnóstico de COVID-19 con PCR para el ARN de Sars-Cov2 positiva.se incluyeron en total 722 pacientes, la diferencia sodio menos cloro31 mEq/L no se asocia a incremento del riesgo de muerte a 28 días (p = 1.172, OR: 1.35; IC95%: 0.87-2.08) ni requerimiento de ventilación mecánica (p = 0.47, OR: 1.19; IC95%: 0.76-1.86), pero sí a mayor riesgo de presentación de LRA (p0.05, OR: 2.04; IC95%: 1.33- 3.14) y mayor estancia hospitalaria (p0.05).la diferencia sodio menos cloro31 mEq/L en las primeras horas del ingreso se asocia a mayor riesgo de presentar lesión renal aguda durante la estancia hospitalaria en pacientes con la COVID-19, así como mayor tiempo de estancia hospitalaria. |
