Asociación entre parámetros clínicos, bioquímicos y ecográficos en pacientes graves ingresados al servicio de emergencia del HDLV con la mortalidad al egreso de la hospitalización

摘要

Background: The state of shock is an emerging condition that must be detected in a timely manner to avoid the mortality of patients in critical conditions. For this, the utility of clinical parameters (shock index and REMS scale), laboratory (lactate measurement), and image studies (Eco RUSH) were analyzed; correlating with patient survival. Materials and methods: This is a retrospective analytical study in 58 critically ill patients attended at Hospital de los Valles in the Emergency Department for presenting hypotension and shock manifestations from the years 2010 to 2014. Patients were categorized based on their final condition when they were discharge from the hospital. Clinical, laboratory and imaging parameters were compared between the two groups (survived or deceased) using the T Student's test compared to the normality of the data, and using the exact Fischer and Chi-square test. Results: There was no statistically significant association between the measured parameters and the patient’s mortality. However, there is a percentage difference in the data base. Conclusion: It is important to have a protocol that allows the assessment of severity and timely diagnosis of shock in the emergency room, without the need for invasive or costly procedures. The shock index and REMS scale could be applied to all severe ill patients, and RUSH ultrasound and lactate measurement can be applied only to patients who strictly require it, with the purpose to avoid complications and save time and unnecessary costs. The study did not demonstrate significant associations between the workup and the mortality data of the patients. It is thought that a more precise and extensive range is needed, in order to reject definitely the association of the mortality and diagnostic parameters performed.