Factores asociados a comorbilidades en la estancia de pacientes en cuidados críticos, Hospital Carlos Andrade Marín, Quito, 2020

ABSTRACT Introduction: The critical care patient is susceptible to many vulnerabilities during their hospitalization time, the prevalence of chronic diseases, physical changes in aging, deterioration of functional status, invasive medical procedures expose the elderly to in-hospital complications and development of comorbidities. Objectives: To determine the main risk factors associated with comorbidities during the stay in critical care for adults at Carlos Andrade Marín hospital in older patients, conducting a descriptive study from provided statistical data on the prevalence, factors risk, comorbidities, complications, and how it influences the clinical evolution of the patients. Material and Methods: It is a descriptive, quantitative, longitudinal, and documentary study that was carried out, which includes 110 medical records of patients who presented at least 48 hours of hospitalization time and included criteria admitted to the area of critical care, service of Emergencies, Carlos Andrade Marín hospital from January to December 2020. Results: About the 110 cases, it was determined that 52.7% of the patients in our study are male, 29% presented respiratory failure as a clinical admission diagnosis, which presented arterial hypertension (49.09%) and diabetes mellitus (29.09%) as the main intrinsic risk factors, invasive medical procedures, mainly mechanical ventilation (34.5%) was the main factor extrinsic. 75% of the patients developed some comorbidity during their stay. The most frequent discomfort was: shock (27.27%), pneumonia (26.36%), and infections associated with health care (19.09%), which are related to nosocomial diseases. The most used diagnostic method for the identification of nosocomial microorganisms was the tracheal aspirate culture (38%), the most frequent bacteria being Klebsiella Pneumoniae (20%), Pseudomonas Aeuruginosa (16%), and Escherichia coli (13.33%) . Regarding hospital stay, 48% of the population maintained a short stay of 2 to 3 days. Still, a group of patients who developed pneumonia associated with mechanical ventilation (12.05%) held a time greater than seven days. Regarding the reason for discharge, it was possible to determine that 50.91% of the population that presented some inhospital comorbidity died. The main causes were shock and nosocomial infections. Conclusions: The development of in-hospital comorbidities is more frequent in the elderly since they tend to have a greater predisposition to develop diseases and complications; hypertension and diabetes mellitus are the primary triggers of in-hospital complications. Likewise, invasive medical procedures are associated with a high development of comorbidities and infections related to health care. Shock and pneumonia are the main conditions that increase hospitalization days and hospital mobility. Mortality—overshadowing the clinical evolution of the hospitalized patient in critical care of adults. Keywords: comorbidity, risk factors, elderly, hospital stay. Reviewed by: Mgs. Marcela González Robalino English Professor c.c. 0603017708

• Auteur principal: Díaz Carrión, Rodrigo Abel (author)
• Autres auteurs: Aguirre Ortega, Joel Alexander (author)
• Format: bachelorThesis
• Langue: spa
• Publié: 2021
• Sujets: comorbilidad; factores de riesgo; adulto mayo; estancia hospitalaria
• Accès en ligne: http://dspace.unach.edu.ec/handle/51000/8099