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

Introducción: 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 temp...

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Autores:
Alvarado Castell, Huber
Caicedo Solarte, William Albeiro
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2025
Institución:
Universidad Libre
Repositorio:
RIU - Repositorio Institucional UniLibre
Idioma:
spa
OAI Identifier:
oai:repository.unilibre.edu.co:10901/31525
Acceso en línea:
https://hdl.handle.net/10901/31525
Palabra clave:
Trombocitopenia
Mortalidad
Unidades de cuidados intensivos
Análisis de supervivencia (Biometría)
Septic shock
Thrombocytopenia
In-hospital mortality
Clinical predictors
Intensive care units (ICUs)
Survival analysis
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openAccess
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id RULIBRE2_bda11fc7bf120a66acaa58c3db178127
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network_acronym_str RULIBRE2
network_name_str RIU - Repositorio Institucional UniLibre
repository_id_str
dc.title.spa.fl_str_mv 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
dc.title.alternative.spa.fl_str_mv Characterization of thrombocytopenia as an early predictor of mortality in patients with septic shock: a retrospective study in a healthcare institution in Barranquilla, 2021–2023
title 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
spellingShingle 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
Trombocitopenia
Mortalidad
Unidades de cuidados intensivos
Análisis de supervivencia (Biometría)
Septic shock
Thrombocytopenia
In-hospital mortality
Clinical predictors
Intensive care units (ICUs)
Survival analysis
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
dc.creator.fl_str_mv Alvarado Castell, Huber
Caicedo Solarte, William Albeiro
dc.contributor.advisor.none.fl_str_mv Maestre Serrano, Ronald Yesid
Fernández Chica, Dinno Alberto
dc.contributor.author.none.fl_str_mv Alvarado Castell, Huber
Caicedo Solarte, William Albeiro
dc.subject.spa.fl_str_mv Trombocitopenia
Mortalidad
Unidades de cuidados intensivos
Análisis de supervivencia (Biometría)
topic Trombocitopenia
Mortalidad
Unidades de cuidados intensivos
Análisis de supervivencia (Biometría)
Septic shock
Thrombocytopenia
In-hospital mortality
Clinical predictors
Intensive care units (ICUs)
Survival analysis
dc.subject.subjectenglish.spa.fl_str_mv Septic shock
Thrombocytopenia
In-hospital mortality
Clinical predictors
Intensive care units (ICUs)
Survival analysis
description Introducción: 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.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-07-17T20:45:21Z
dc.date.available.none.fl_str_mv 2025-07-17T20:45:21Z
dc.date.created.none.fl_str_mv 2025-06-20
dc.type.local.spa.fl_str_mv Tesis de Especialización
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url https://hdl.handle.net/10901/31525
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spelling Maestre Serrano, Ronald YesidFernández Chica, Dinno AlbertoAlvarado Castell, HuberCaicedo Solarte, William AlbeiroBarranquilla2025-07-17T20:45:21Z2025-07-17T20:45:21Z2025-06-20https://hdl.handle.net/10901/31525Introducción: 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.Universidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud y Exactas y Naturales -- Especialización en Medicina InternaIntroduction: 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.PDFspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Atribución-NoComercial-SinDerivadas 2.5 Colombiainfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2TrombocitopeniaMortalidadUnidades de cuidados intensivosAnálisis de supervivencia (Biometría)Septic shockThrombocytopeniaIn-hospital mortalityClinical predictorsIntensive care units (ICUs)Survival analysisCaracterización 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 – 2023Characterization of thrombocytopenia as an early predictor of mortality in patients with septic shock: a retrospective study in a healthcare institution in Barranquilla, 2021–2023Tesis de Especializacióninfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisEvans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. 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Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1749448THUMBNAILCASTELL.pdf.jpgCASTELL.pdf.jpgIM Thumbnailimage/jpeg11798http://repository.unilibre.edu.co/bitstream/10901/31525/4/CASTELL.pdf.jpgfbf06329fdaa83da18b5240a58c18538MD54CASTELL AUTORIZACIÓN.pdf.jpgCASTELL AUTORIZACIÓN.pdf.jpgIM Thumbnailimage/jpeg28858http://repository.unilibre.edu.co/bitstream/10901/31525/5/CASTELL%20AUTORIZACI%c3%93N.pdf.jpg374aabafe4ff69471a6181ece645ffdfMD55LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repository.unilibre.edu.co/bitstream/10901/31525/3/license.txt8a4605be74aa9ea9d79846c1fba20a33MD53ORIGINALCASTELL.pdfCASTELL.pdfArchivo del trabajo de gradoapplication/pdf1642611http://repository.unilibre.edu.co/bitstream/10901/31525/1/CASTELL.pdfdb7b64cdbfdf15b8b3fca54fc4fdc179MD51CASTELL AUTORIZACIÓN.pdfCASTELL AUTORIZACIÓN.pdfAutorización para la publicaciónapplication/pdf15639140http://repository.unilibre.edu.co/bitstream/10901/31525/2/CASTELL%20AUTORIZACI%c3%93N.pdfa9d67fd4c8560cd5930751da2b9d24eeMD5210901/31525oai:repository.unilibre.edu.co:10901/315252025-11-06 12:28:04.374Repositorio Institucional Unilibrerepositorio@unilibrebog.edu.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