Diseño y validación de una herramienta para la predicción de desenlaces adversos en pacientes con obstrucción intestinal por bridas: La escala HALVIC

Autores/as

  • Andrea Carolina Quiroga-Centeno Universidad Industrial de Santander, Bucaramanga, Colombia. https://orcid.org/0000-0002-1072-4200
  • María Camila Pinilla-Chávez Universidad Industrial de Santander, Bucaramanga, Colombia.
  • Diego Fernando Chaparro-Zaraza Universidad Industrial de Santander, Bucaramanga, Colombia.
  • Katherine Hoyos-Rizo Universidad Industrial de Santander, Bucaramanga, Colombia. https://orcid.org/0000-0001-7320-9532
  • Pedro Felipe Pinilla-Merchán Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia. https://orcid.org/0000-0002-7689-2282
  • Juan Paulo Serrano-Pastrana Universidad Industrial de Santander, Bucaramanga, Colombia.
  • Sergio Alejandro Gómez Ochoa Fundación Cardiovascular de Colombia, Floridablanca, Colombia. https://orcid.org/0000-0002-1396-5042

DOI:

https://doi.org/10.30944/20117582.2288

Palabras clave:

obstrucción intestinal, adherencias tisulares, isquemia, mortalidad, valor predictivo, cirugía

Resumen

Introducción. La obstrucción intestinal por bridas representa una causa común de consulta a los servicios de urgencias, pero hay poca claridad sobre qué pacientes tienen mayor riesgo de desarrollar complicaciones. El objetivo de este estudio fue diseñar y validar una escala de predicción de riesgo de desenlaces adversos en pacientes con obstrucción intestinal por bridas.

Métodos. Estudio de cohorte retrospectivo realizado a partir de la base de datos MIMIC-IV. Se incluyeron pacientes adultos admitidos al servicio de urgencias entre 2008 y 2019, con diagnóstico de obstrucción intestinal por bridas. El desenlace principal fue el compuesto de resección intestinal, ingreso a unidad de cuidados intensivos y mortalidad por cualquier causa. Se diseñó una escala de predicción de riesgo asignando un puntaje a cada variable.

Resultados. Se incluyeron 513 pacientes, 63,7 % hombres. El desenlace compuesto se presentó en el 25,7 % de los casos. La edad, historia de insuficiencia cardiaca y enfermedad arterial periférica, nivel de hemoglobina, recuento de leucocitos e INR constituyeron el mejor modelo de predicción de estos desenlaces (AUC 0,75). A partir de este modelo, se creó la escala simplificada HALVIC, clasificando el riesgo del desenlace compuesto en bajo (0-2 puntos), medio (3-4 puntos) y alto (5-7 puntos).

Conclusión. La escala HALVIC es una herramienta de predicción simple y fácilmente aplicable. Puede identificar de manera precisa los pacientes con obstrucción intestinal por bridas con alto riesgo de complicaciones, permitiendo el ajuste individualizado de las estrategias de manejo para mejorar los desenlaces.

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Biografía del autor/a

Andrea Carolina Quiroga-Centeno, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médica, especialista en Cirugía general.

María Camila Pinilla-Chávez, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médica, residente de Cirugía General.

Diego Fernando Chaparro-Zaraza, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico.

Katherine Hoyos-Rizo, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médica, residente de Cirugía General.

Pedro Felipe Pinilla-Merchán, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.

Médico.

Juan Paulo Serrano-Pastrana, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico, especialista en Cirugía general, jefe, Departamento de Cirugía.

Sergio Alejandro Gómez Ochoa, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Médico, magíster en Bioinformática y Bioestadística, Grupo de Estudios Epidemiológicos.

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Publicado

2023-01-01

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(1)
Quiroga-Centeno, A. C.; Pinilla-Chávez, M. C.; Chaparro-Zaraza, D. F.; Hoyos-Rizo, K.; Pinilla-Merchán, P. F.; Serrano-Pastrana, J. P.; Gómez Ochoa, S. A. Diseño Y validación De Una Herramienta Para La predicción De Desenlaces Adversos En Pacientes Con obstrucción Intestinal Por Bridas: La Escala HALVIC. Rev Colomb Cir 2023, 38, 84-100.

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