Impacto clínico de la pancitopenia en pacientes hospitalizados
Objective: To determine etiology, clinical manifestations, morbidity and mortality, and diagnostic and therapeutic resources used in patients with pancytopenia. Materials and methods: Protocolized, descriptive and observational study of 14 months in patients with pancytopenia defined by hemoglob...
Guardado en:
| Publicado en: | Revista Médica Universitaria |
|---|---|
| Autores principales: | , , , , , |
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=2691 |
| todos_str_mv |
1221 2688 Área de Hematología - FCM - Uncuyo HospLagClinMed HospLagClinMed HospLagClinMed spa UNCuyo FCM Dto. Medicina Interna UNCuyo FCM Dto. Medicina Interna |
|---|---|
| autor_str_mv |
Carena, José Alberto Cassata, Andrea Mosso, Marcelo Osay, Liliana Prieto, Sebastián Salomón, Susana Elsa |
| disciplina_str_mv |
Ciencias médicas |
| descriptores_str_mv |
Clínica médica Datos estadísticos Etiología Indicadores de morbimortalidad Infección Medicina clínica Mendoza (Argentina) Pacientes hospitalizados Pancitopenia Quimioterapia Recuento leucocitario Trastornos sanguíneos |
| titulo_str_mv |
Clinical impact of pancytopenia in hospitalized patients Impacto clínico de la pancitopenia en pacientes hospitalizados |
| description_str_mv |
Objective: To determine etiology, clinical manifestations, morbidity and
mortality, and diagnostic and therapeutic resources used in patients with
pancytopenia.
Materials and methods: Protocolized, descriptive and observational study of
14 months in patients with pancytopenia defined by hemoglobin (Hb) <12 g / dL,
platelets <150.000/uL and leukocytes <3.800/uL.
Results: We diagnosed 54 cases of pancytopenia. Prevalence: 22/1000
discharges. Average age: 48.72 years (SD±20.64), 16 (29.63%) were >65 years
and 29 (53.70%) men. The mean hospital stay was 17.13 (SD±13.22) vs 7.25
days (SD±5.4) in the service (p<0.0001). Charlson score: 7.16 (SD±2.96) and
APACHE II score: 12 (SD±5.04). In 45 cases (83.33%; CI95%70.71-92.08) was
secondary to bone marrow involvement; 22 cases (40.74%; CI95%27.57-54.97)
were induced by chemotherapy (15 hematologic neoplasms and 7 solid
tumors), 11 (20.37%; CI95%10.63-33.53) were caused by myeloptisis, 4 cases
(7.41%; CI95%2.06-17.89) by megaloblastosis, 9 cases (16.66%; CI95%7.92-
29.29) by hypersplenism and 9 by infections. Comorbidities were present in
96.29% (CI95%87.25-99.55). The systemic inflammatory response syndrome
(85.19%), anemia (77.8%) and cutaneous purpura (50%) were the most
frequent clinical manifestations. 81.48% presented sepsis (CI95%68,57-90,75)
and 29.63% (CI95%17.98-46.31) had major haemorrhages. Infections occurred
in 81.48% of patients, 50% were nosocomial and 65.91% clinically documented.
34.09% (CI95%20.49-49.92) had microbiological isolation and bacteremia in
29.55% of cases. 51.85% (CI95%37.84-65.66) developed febrile neutropenia
(75% after chemotherapy). 64.81% received blood products and granulocyte -
colony stimulating factors in 46.34% (CI95%32.62-60.39). Crude mortality was
higher than the overall average of the Service (16.66 vs 8.65%) (p = 0.07).-
Conclusions: Pancytopenia in hospitalized patients was characterized as
being mainly secondary to bone marrow involvement, hypersplenism and
infections, associated with prolonged hospitalization, high rates of comorbidity,
infectious complications and higher mortality.
Objetivo: Determinar etiología, manifestaciones clínicas, morbimortalidad y recursos diagnósticos y terapéuticos utilizados en pacientes internados con pancitopenia. Material y métodos: Estudio protocolizado, descriptivo y observacional de 14 meses. Criterios de inclusión: pacientes internados con pancitopenia definida por hemoglobina (Hb) <12 g/dL; plaquetas <150.000/ mL y leucocitos <3.800/mL. Los datos fueron analizados con Epi Info 6.04. Resultados: Se diagnosticaron 54 casos de pancitopenia. Prevalencia: 22/1.000 egresos. Edad media: 48,72 años (DS±20,64); 29,63% fueron > 65 años y 53,70% hombres. Permanencia media: 17,13 días (DS±13,22) vs 7,25 días (DS±5,4) del Servicio (p<0.0001). Charlson medio: 7,16 (DS±2,96) y APACHEII medio: 12 (DS±5,04). El 83,33% (45/54, IC95%70,71-92,08) de las pancitopenias fueron secundarias a compromiso medular, 22 casos (40,74%; IC95%27,57-54,97) postquimioterapia (15 en neoplasias oncohematológicas y 7 en sólidas), 11 (20,37%; IC95%10,63-33,53) por mieloptisis y 4 casos (7,41%; IC95%2,06-17,89) por megaloblastosis. El 16,66% (9/54; IC95%7,92- 29,29) fue secundaria a hiperesplenismo y el 16,66% asociadas a infecciones (3 casos por SIDA). Se realizó estudio de médula ósea en 19 casos (35,18%). El 96,29% (IC95%87,25-99,55) presentó comórbidas. El síndrome de respuesta inflamatoria sistémica (85,19%), síndrome anémico (77,8%) y púrpura (50%) fueron las manifestaciones clínicas más frecuentes. Presentó sepsis el 81,48% (IC95%68,57-90,75) y el 29,63% (IC95%17,98-46,31) hemorragias. El 81,48% tuvo infecciones; el 50% de origen nosocomial y el 65,91% clínicamente documentadas. El 34,09% (IC95%20,49-49,92) tuvo aislamiento microbiológico, con hemocultivos positivos en 29,55%. El 51,85% (IC95%37,84-65,66) desarrolló neutropenia febril (75% postquimioterapia). El 64,81% recibió hemoderivados y factores estimulantes de colonias (G-CSF) el 46,34% (IC95%32,62-60,39). La mortalidad fue mayor a la media global del Servicio (16,66 vs 8,65%)(p=0.07).- Conclusiones: Las pancitopenias en pacientes hospitalizados se caracterizaron por ser secundarias a compromiso medular, hiperesplenismo e infecciones, asociarse a permanencia prolongada, altos índices de comorbilidad, complicaciones infecciosas, y mayor mortalidad que la media global del Servicio. |
| object_type_str_mv |
Textual: Revistas |
| id |
2691 |
| plantilla_str |
Artículo de Revista |
| record_format |
article |
| container_title |
Revista Médica Universitaria |
| journal_title_str |
Revista Médica Universitaria |
| journal_id_str |
r-1221 |
| container_issue |
Revista Médica Universitaria |
| container_volume |
Vol. 4, no. 4 |
| journal_issue_str |
Vol. 4, no. 4 |
| tipo_str |
textuales |
| type_str_mv |
Articulos |
| title_full |
Impacto clínico de la pancitopenia en pacientes hospitalizados |
| title_fullStr |
Impacto clínico de la pancitopenia en pacientes hospitalizados Impacto clínico de la pancitopenia en pacientes hospitalizados |
| title_full_unstemmed |
Impacto clínico de la pancitopenia en pacientes hospitalizados Impacto clínico de la pancitopenia en pacientes hospitalizados |
| description |
Objective: To determine etiology, clinical manifestations, morbidity and
mortality, and diagnostic and therapeutic resources used in patients with
pancytopenia.
Materials and methods: Protocolized, descriptive and observational study of
14 months in patients with pancytopenia defined by hemoglobin (Hb) <12 g / dL,
platelets <150.000/uL and leukocytes <3.800/uL.
Results: We diagnosed 54 cases of pancytopenia. Prevalence: 22/1000
discharges. Average age: 48.72 years (SD±20.64), 16 (29.63%) were >65 years
and 29 (53.70%) men. The mean hospital stay was 17.13 (SD±13.22) vs 7.25
days (SD±5.4) in the service (p<0.0001). Charlson score: 7.16 (SD±2.96) and
APACHE II score: 12 (SD±5.04). In 45 cases (83.33%; CI95%70.71-92.08) was
secondary to bone marrow involvement; 22 cases (40.74%; CI95%27.57-54.97)
were induced by chemotherapy (15 hematologic neoplasms and 7 solid
tumors), 11 (20.37%; CI95%10.63-33.53) were caused by myeloptisis, 4 cases
(7.41%; CI95%2.06-17.89) by megaloblastosis, 9 cases (16.66%; CI95%7.92-
29.29) by hypersplenism and 9 by infections. Comorbidities were present in
96.29% (CI95%87.25-99.55). The systemic inflammatory response syndrome
(85.19%), anemia (77.8%) and cutaneous purpura (50%) were the most
frequent clinical manifestations. 81.48% presented sepsis (CI95%68,57-90,75)
and 29.63% (CI95%17.98-46.31) had major haemorrhages. Infections occurred
in 81.48% of patients, 50% were nosocomial and 65.91% clinically documented.
34.09% (CI95%20.49-49.92) had microbiological isolation and bacteremia in
29.55% of cases. 51.85% (CI95%37.84-65.66) developed febrile neutropenia
(75% after chemotherapy). 64.81% received blood products and granulocyte -
colony stimulating factors in 46.34% (CI95%32.62-60.39). Crude mortality was
higher than the overall average of the Service (16.66 vs 8.65%) (p = 0.07).-
Conclusions: Pancytopenia in hospitalized patients was characterized as
being mainly secondary to bone marrow involvement, hypersplenism and
infections, associated with prolonged hospitalization, high rates of comorbidity,
infectious complications and higher mortality.
|
| dependencia_str_mv |
Facultad de Ciencias Médicas |
| title |
Impacto clínico de la pancitopenia en pacientes hospitalizados |
| spellingShingle |
Impacto clínico de la pancitopenia en pacientes hospitalizados Clínica médica Datos estadísticos Etiología Indicadores de morbimortalidad Infección Medicina clínica Mendoza (Argentina) Pacientes hospitalizados Pancitopenia Quimioterapia Recuento leucocitario Trastornos sanguíneos Carena, José Alberto Cassata, Andrea Mosso, Marcelo Osay, Liliana Prieto, Sebastián Salomón, Susana Elsa |
| topic |
Clínica médica Datos estadísticos Etiología Indicadores de morbimortalidad Infección Medicina clínica Mendoza (Argentina) Pacientes hospitalizados Pancitopenia Quimioterapia Recuento leucocitario Trastornos sanguíneos |
| topic_facet |
Clínica médica Datos estadísticos Etiología Indicadores de morbimortalidad Infección Medicina clínica Mendoza (Argentina) Pacientes hospitalizados Pancitopenia Quimioterapia Recuento leucocitario Trastornos sanguíneos |
| author |
Carena, José Alberto Cassata, Andrea Mosso, Marcelo Osay, Liliana Prieto, Sebastián Salomón, Susana Elsa |
| author_facet |
Carena, José Alberto Cassata, Andrea Mosso, Marcelo Osay, Liliana Prieto, Sebastián Salomón, Susana Elsa |
| title_sort |
Impacto clínico de la pancitopenia en pacientes hospitalizados |
| title_short |
Impacto clínico de la pancitopenia en pacientes hospitalizados |
| url |
https://bdigital.uncu.edu.ar/fichas.php?idobjeto=2691 |
| estado_str |
3 |
| building |
Biblioteca Digital |
| filtrotop_str |
Biblioteca Digital |
| collection |
Artículo de Revista |
| institution |
Sistema Integrado de Documentación |
| indexed_str |
2023-04-25 00:38 |
| _version_ |
1764120345649872896 |
