Relación de los biomarcadores serológicos y fecales con las complicaciones que llevan a la hospitalización en pacientes con enfermedad inflamatoria intestinal
| dc.contributor.advisor | Moscote Granadillo, Mario Joaquín | |
| dc.contributor.advisor | Mendoza Torres, Evelyn | |
| dc.contributor.author | Jaimes Fuentes, Víctor José | |
| dc.contributor.author | Pertuz Rebolledo, German José | |
| dc.coverage.spatial | Barranquilla | spa |
| dc.creator.email | victorj-jaimesf@unilibre.edu.co | spa |
| dc.creator.email | germanj-pertuzr@unilibre.edu.co | spa |
| dc.date.accessioned | 2025-07-19T00:34:48Z | |
| dc.date.available | 2025-07-19T00:34:48Z | |
| dc.date.created | 2025-06-28 | |
| dc.description.abstract | Introducción: La Enfermedad Inflamatoria Intestinal (EII), que incluye la enfermedad de Crohn (EC) y la colitis ulcerativa (CU), es una patología crónica del tracto gastrointestinal caracterizada por inflamación de la mucosa y sistémica. Aunque se han identificado biomarcadores serológicos y fecales útiles en la evaluación de la actividad inflamatoria, su relación con complicaciones clínicas que conllevan a hospitalización aún no está completamente elucidada en contextos clínicos latinoamericanos. Objetivo: Establecer la relación de los biomarcadores serológicos y fecales con las complicaciones que llevan a la hospitalización en pacientes con EII atendidos en una IPS de Barranquilla (Atlántico) entre enero de 2021 y diciembre de 2023. Materiales y Métodos: Estudio observacional, retrospectivo, transversal analítico. Se incluyeron 62 pacientes hospitalizados con diagnóstico confirmado de EC o CU. Se recopilaron variables sociodemográficas, clínicas, tipo de complicación, duración de hospitalización y niveles de biomarcadores: PCR, VSG, TNF-α, IL-6, IL-8, calprotectina, lactoferrina, ASCA y p-ANCA. Se emplearon pruebas de comparación de medianas (Wilcoxon, Kruskal-Wallis), pruebas de asociación (Chi-cuadrado, Fisher), correlación de Spearman y análisis de componentes principales (PCA). Resultados: El 60% de los pacientes presentó CU y el 40% EC. La mediana de edad fue 49 años, sin diferencias significativas entre grupos. Las complicaciones difirieron entre subtipos: la hemorragia masiva fue más frecuente en CU (92%), mientras que las fístulas (28%) y abscesos (20%) predominaron en EC. Los pacientes con fístulas presentaron la mayor estancia hospitalaria (mediana 24.5 días; p<0.001). En cuanto a biomarcadores, IL-8 y lactoferrina fecal estuvieron significativamente elevadas en CU y en pacientes con hemorragia masiva (p<0.001), mientras que IL-6 fue más alta en pacientes con estenosis y abscesos (p=0.042). La calprotectina fecal fue significativamente mayor en pacientes con fístulas (mediana 930 µg/g; p=0.027). No se encontraron diferencias relevantes en PCR, TNF-α ni VSG entre grupos. En el análisis serológico, la positividad para p-ANCA fue más frecuente en CU (54%) y la de ASCA en EC (56%) (p<0.05). El PCA mostró una diferenciación clara en los perfiles inflamatorios entre CU y EC, destacándose lactoferrina, IL-8 y TNF-α como variables influyentes en CU, mientras que IL-6 y el tiempo de estancia fueron determinantes en EC. Conclusiones: Los biomarcadores serológicos y fecales mostraron asociaciones específicas con los tipos de complicaciones y características clínicas en pacientes con EII hospitalizados. Estos resultados respaldan su aplicación como herramientas pronósticas para anticipar complicaciones graves, optimizar el manejo terapéutico y reducir la carga de hospitalización, especialmente en contextos clínicos de alta prevalencia. | spa |
| dc.description.abstractenglish | Background: Inflammatory Bowel Disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic condition of the gastrointestinal tract characterized by mucosal and systemic inflammation. Although several serological and fecal biomarkers are used to assess inflammatory activity, their relationship with clinical complications leading to hospitalization is not yet fully elucidated, especially in Latin American clinical contexts. Objective: To establish the relationship between serological and fecal biomarkers and complications leading to hospitalization in patients with IBD treated at a healthcare institution in Barranquilla (Atlántico, Colombia) between January 2021 and December 2023. Materials and Methods: A retrospective, observational, analytical cross-sectional study was conducted. A total of 62 hospitalized patients with confirmed diagnoses of CD or UC were included. Sociodemographic, clinical, and hospitalization data were collected, along with levels of biomarkers: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), TNF-α, IL-6, IL-8, fecal calprotectin, fecal lactoferrin, ASCA, and p-ANCA. Statistical analyses included non-parametric tests (Wilcoxon, Kruskal-Wallis), association tests (Chi-square, Fisher's exact), Spearman correlations, and principal component analysis (PCA). Results: Of the 62 patients, 60% had UC and 40% had CD. The median age was 49 years with no significant differences between groups. Complications varied: massive gastrointestinal bleeding predominated in UC (92%), while fistulas (28%) and abscesses (20%) were more frequent in CD. Patients with fistulas had the longest hospital stays (median 24.5 days; p<0.001). IL-8 and fecal lactoferrin were significantly elevated in UC and in patients with massive bleeding (p<0.001), whereas IL-6 levels were highest in patients with stenosis and abscesses (p=0.042). Fecal calprotectin was significantly higher in those with fistulas (median 930 µg/g; p=0.027). No significant differences were found in CRP, TNF-α, or ESR across groups. Regarding serological markers, p-ANCA positivity was more frequent in UC (54%), while ASCA predominated in CD (56%) (p<0.05). PCA revealed distinct inflammatory profiles between UC and CD: lactoferrin, IL-8, and TNF-α were most influential in UC; IL-6 and hospital stay duration were most associated with CD. Conclusions: Serological and fecal biomarkers were specifically associated with the types and clinical characteristics in hospitalized IBD patients. These findings support their use as prognostic tools to anticipate severe complications, guide therapeutic decision-making, and reduce hospitalization burden, particularly in high-prevalence settings. | spa |
| dc.description.sponsorship | Universidad libre seccional Barranquilla -- Facultad de ciencias de la salud -- Especialización Medicina Interna | spa |
| dc.format | spa | |
| dc.identifier.uri | https://hdl.handle.net/10901/31546 | |
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| dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
| dc.rights.coar | http://purl.org/coar/access_right/c_abf2 | spa |
| dc.rights.license | Atribución-NoComercial-SinDerivadas 2.5 Colombia | spa |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | spa |
| dc.subject | Enfermedad inflamatoria intestinal | spa |
| dc.subject | Colitis ulcerativa | spa |
| dc.subject | Enfermedad de Crohn | spa |
| dc.subject | Biomarcadores | spa |
| dc.subject | Complicaciones | spa |
| dc.subject | Hospitalización | spa |
| dc.subject | IL-6 | spa |
| dc.subject | IL-8 | spa |
| dc.subject | Calprotectina | spa |
| dc.subject | Lactoferrina | spa |
| dc.subject.lemb | Relación de los biomarcadores serológicos y fecales con las complicaciones que llevan a la hospitalización en pacientes con enfermedad inflamatoria intestinal | spa |
| dc.subject.subjectenglish | Inflammatory Bowel Disease | spa |
| dc.subject.subjectenglish | Ulcerative Colitis | spa |
| dc.subject.subjectenglish | Crohn’s Disease | spa |
| dc.subject.subjectenglish | Biomarkers | spa |
| dc.subject.subjectenglish | Hospitalization | spa |
| dc.subject.subjectenglish | IL-6 | spa |
| dc.subject.subjectenglish | IL-8 | spa |
| dc.subject.subjectenglish | Calprotectin | spa |
| dc.subject.subjectenglish | Lactoferrin | spa |
| dc.title | Relación de los biomarcadores serológicos y fecales con las complicaciones que llevan a la hospitalización en pacientes con enfermedad inflamatoria intestinal | spa |
| dc.type.coar | http://purl.org/coar/resource_type/c_7a1f | spa |
| dc.type.driver | info:eu-repo/semantics/bachelorThesis | spa |
| dc.type.hasversion | info:eu-repo/semantics/acceptedVersion | spa |
| dc.type.local | Tesis de Especialización | spa |
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