Trombocitopenia versus SOFA para predecir mortalidad en pacientes con sepsis en la Unidad de Cuidados Intensivos de un hospital de tercer nivel de Guatemala

Nancy Escobar Jímenez; Jorge Ranero Meneses; André Chocó-Cedillos

doi:10.54495/Rev.Cientifica.v29i1.46

Authors

Nancy Escobar Jímenez Faculty of Medical Sciences, University of San Carlos de Guatemala
Jorge Ranero Meneses Guatemalan Institute of Social Security
André Chocó-Cedillos Holistic Care of HVI and Chronic Infections Unit, Roosevelt Hospital

DOI:

https://doi.org/10.54495/Rev.Cientifica.v29i1.46

Keywords:

Organ Dysfunction Scores, Platelet Count, Sepsis, Septic Shock

Abstract

The most common coagulation disorder in the intensive care unit is thrombocytopenia. Considering the fundamental role of platelets in hemostasis and as markers of disseminated intravascular coagulation, a signiﬁcant decrease in platelet counts is alarming in the context of septic patients, and it is known to be a predictor of death. The objective was to compare the ability of the platelet count with the Sequential Organ Failure Assessment (SOFA) to predict death in patients with severe sepsis or septic shock. A longitudinal study was conducted with a sample of 29 consecutive cases evaluated during January to December 2015 in the Intensive Care Unit of the General Hospital of Diseases (HGE) of the Guatemalan Social Security Institute. Platelet and SOFA counts were performed at the ﬁrst and the ﬁfth day of hospitalization,
documenting the outcome of the patients. 51.7% of the patients were men and 48.3% were women, with an average age of 62.0 (16.9) years, median SOFA on admission of 10 units (Q1=4, Q3=14) and platelet median on admission of 196000 (Q1=100000, Q3=250000). e univariate association between thrombocytopenia and death was signiﬁcant (p = .021, RR = 2.45, CI 95% [1.21, 4.99]). According to a Bootstrap test, there is no signiﬁcant diﬀerence between the predictive capacity of SOFA and platelet count (p = .965). It was concluded that the presence of thrombocytopenia is a simple predictor of death in patients with severe sepsis or septic shock, with similar capacity to SOFA.

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