Pronóstico de muerte en los pacientes críticamente enfermos según el Índice NUTRIC de riesgo nutricional

Julia Matilde Pupo Jiménez; Julio César González Aguilera; Jorge Omar Cabrera Lavernia; Gloria Mabel Martí Garcés

Pronóstico de muerte en los pacientes críticamente enfermos según el Índice NUTRIC de riesgo nutricional

Julia Matilde Pupo Jiménez, Julio César González Aguilera, Jorge Omar Cabrera Lavernia, Gloria Mabel Martí Garcés

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Introducción: La desnutrición en el paciente críticamente enfermo comporta una alta morbimortalidad. La determinación del riesgo nutricional serviría para intervenir efectivamente en el pronóstico del enfermo. Objetivo: Evaluar la influencia del índice NUTRIC de riesgo nutricional sobre el pronóstico de muerte del paciente crítico. Locación del estudio: Unidad de Cuidados Intermedios (UCIM), Hospital General Universitario “Carlos Manuel de Céspedes” (Bayamo, Granma). Diseño del estudio: Prospectivo, longitudinal, con dos cortes transversales: Primer corte: Al ingreso en la UCIM; y Segundo corte: Al egreso. Serie de estudio: Ciento cuarenta y ocho pacientes (Hombres: 61.5%; Edades ≥ 60 años: 77.0%; APACHE II: 19 ± 6; SOFA: 5 ± 3; Ventilación mecánica: 24.3%; Estadía promedio en la UCIM: 11.7 ± 20.5 días) atendidos entre el 1^ro de Enero y el 31 de Marzo del 2017. Métodos: Se examinaron las asociaciones entre el índice NUTRIC y la condición al egreso (Vivo/Fallecido) del paciente. Resultados: La tasa de mortalidad por-todas-las-causas fue del 42.6%. El índice NUTRIC promedio fue de 5 ± 2. El 27.7% de los pacientes presentó puntajes NUTRIC ≥ 5. La mortalidad se asoció fuertemente con el puntaje NUTRIC: NUTRIC ≥ 5: Vivos: 12.9% vs. Fallecidos: 47.6% (Diferencia = +34.7;ji-cuadrado = 21.7; p < 0.05). Los pacientes con puntajes NUTRIC elevados tuvieron un riesgo mayor de fallecer (RR = 1.7; IC 95%: 1.3 – 2.1; p < 0.05). Conclusiones: El índice NUTRIC señala a los pacientes críticamente enfermos en riesgo de fallecer.

Palabras clave

Puntaje NUTRIC; Nutrición; Paciente críticamente enfermo; Evaluación nutricional; Desnutrición hospitalaria; Mortalidad

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