Caracterización de la trombocitopenia como predictor temprano de mortalidad en pacientes con choque séptico: estudio retrospectivo en una institución prestadora de servicios de salud de Barranquilla, 2021 – 2023

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dc.contributor.advisorMaestre Serrano, Ronald Yesid
dc.contributor.advisorFernández Chica, Dinno Alberto
dc.contributor.authorAlvarado Castell, Huber
dc.contributor.authorCaicedo Solarte, William Albeiro
dc.coverage.spatialBarranquillaspa
dc.creator.emailwilliama-caicedos@unilibre.edu.cospa
dc.creator.emailhuber-alvaradoc@unilibre.edu.cospa
dc.date.accessioned2025-07-17T20:45:21Z
dc.date.available2025-07-17T20:45:21Z
dc.date.created2025-06-20
dc.description.abstractIntroducción: La trombocitopenia es frecuente en el choque séptico y su valor como marcador pronóstico ha sido discutido. Su accesibilidad en entornos clínicos la convierte en una herramienta útil para estratificación del riesgo de mortalidad. Objetivo: Evaluar la trombocitopenia como predictor temprano de mortalidad hospitalaria a 30 días en pacientes con choque séptico en una institución de cuarto nivel en Barranquilla, 2021–2023. Materiales y Métodos: Estudio observacional, analítico, retrospectivo y de cohorte histórica. Se incluyeron 223 pacientes con choque séptico y trombocitopenia, clasificada por severidad (leve, moderada, severa). Se analizaron variables clínicas, laboratoriales y terapéuticas. Se usaron pruebas de Wilcoxon, Kruskal-Wallis, Chi-cuadrado, análisis de supervivencia (Kaplan-Meier) y regresión de Cox. Significancia estadística: p<0.05. Resultados: El 51% fueron mujeres, con mediana de edad de 54 años. La trombocitopenia fue leve en 48%, moderada en 35% y severa en 17%. La enfermedad renal crónica G4-G5 se asoció con trombocitopenia severa (p=0.041). Todos los pacientes con trombocitopenia severa recibieron transfusión plaquetaria (p<0.001). La trombocitopenia severa se asoció con menor sobrevida a 30 días (log-rank p=0.02). En el análisis multivariado, la trombocitopenia severa (HR: 1.5; p=0.009) y la diabetes tipo 2 (HR: 2.76; p=0.020) fueron predictores independientes de mortalidad. Conclusiones: La trombocitopenia severa es un marcador clínico accesible y útil para predecir mortalidad temprana en choque séptico. Su incorporación rutinaria podría optimizar la estratificación del riesgo y guiar decisiones en cuidados críticos.spa
dc.description.abstractenglishIntroduction: Thrombocytopenia is a common finding in septic shock, and its prognostic value has been the subject of ongoing debate. Its availability in clinical settings makes it a practical tool for mortality risk stratification. Objective: To evaluate thrombocytopenia as an early predictor of 30-day in-hospital mortality in patients with septic shock in a tertiary care institution in Barranquilla, during the period 2021–2023. Materials and Methods: Observational, analytical, retrospective, historical cohort study. A total of 223 patients with septic shock and thrombocytopenia were included, classified by severity (mild, moderate, severe). Clinical, laboratory, and therapeutic variables were analyzed. Statistical tests included Wilcoxon, Kruskal-Wallis, Chi-square, survival analysis (Kaplan-Meier), and Cox regression. Statistical significance was set at p<0.05. Results: Fifty-one percent of patients were female, with a median age of 54 years. Thrombocytopenia was classified as mild in 48%, moderate in 35%, and severe in 17% of cases. Advanced chronic kidney disease (stage G4–G5) was associated with severe thrombocytopenia (p=0.041). All patients with severe thrombocytopenia received platelet transfusions (p<0.001). Severe thrombocytopenia was associated with lower 30-day survival (log-rank p=0.02). In multivariate analysis, severe thrombocytopenia (HR: 1.5; p=0.009) and type 2 diabetes mellitus (HR: 2.76; p=0.020) were independent predictors of mortality. Conclusions: Severe thrombocytopenia is an accessible and valuable clinical marker for predicting early mortality in septic shock. Its routine incorporation could enhance risk stratification and guide decision-making in critical care settings.spa
dc.description.sponsorshipUniversidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud y Exactas y Naturales -- Especialización en Medicina Internaspa
dc.formatPDFspa
dc.identifier.urihttps://hdl.handle.net/10901/31525
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.coarhttp://purl.org/coar/access_right/c_abf2spa
dc.rights.licenseAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/spa
dc.subjectChoque sépticospa
dc.subjecttrombocitopeniaspa
dc.subjectmortalidad hospitalariaspa
dc.subjectpredictores clínicosspa
dc.subjectunidades de cuidados intensivosspa
dc.subjectanálisis de supervivenciaspa
dc.subject.lembTrombocitopeniaspa
dc.subject.lembMortalidadspa
dc.subject.lembUnidades de cuidados intensivosspa
dc.subject.lembAnálisis de supervivencia (Biometría)spa
dc.subject.subjectenglishSeptic shockspa
dc.subject.subjectenglishThrombocytopeniaspa
dc.subject.subjectenglishIn-hospital mortalityspa
dc.subject.subjectenglishClinical predictorsspa
dc.subject.subjectenglishIntensive care units (ICUs)spa
dc.subject.subjectenglishSurvival analysisspa
dc.titleCaracterización de la trombocitopenia como predictor temprano de mortalidad en pacientes con choque séptico: estudio retrospectivo en una institución prestadora de servicios de salud de Barranquilla, 2021 – 2023spa
dc.title.alternativeCharacterization of thrombocytopenia as an early predictor of mortality in patients with septic shock: a retrospective study in a healthcare institution in Barranquilla, 2021–2023spa
dc.type.coarhttp://purl.org/coar/resource_type/c_7a1fspa
dc.type.driverinfo:eu-repo/semantics/bachelorThesisspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localTesis de Especializaciónspa

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