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Factores de riesgo de choque séptico en pacientes mayores con infección del tracto urinario

Takaaki Tsuchiya^1,2, Kenta Taito¹, Yui Ota¹

¹Department of Nephrology and Dialysis, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo, 173-0015, Japan.

Clinical and experimental nephrology

|November 25, 2024

Backgrounds:

Pocos estudios han abordado los factores de riesgo para el desarrollo de choque séptico en pacientes mayores con infecciones del tracto urinario. Decidimos investigar si existe un riesgo similar en los pacientes mayores.

MéTodos:

En este estudio se incluyó a un total de 1478 pacientes adultos mayores (492 hombres, 986 mujeres) de 65 años o más (edad media de 85,1 años) que fueron hospitalizados y tratados por infecciones del tracto urinario; asimismo, mediante una revisión retrospectiva de las historias clínicas de los pacientes, se investigaron los factores que contribuyeron al desarrollo de choque séptico en estos pacientes, incluyendo los patógenos causales y los tratamientos empleados.

Resultados:

Se encontró que la infección del tracto urinario subyacente con urolitiasis era el factor de riesgo más significativo para el desarrollo de choque séptico (p < 0.01). Los pacientes con urolitiasis presentaban una mayor fragilidad, niveles más elevados de pH urinario y de calcio, y mostraron una mayor frecuencia de infecciones causadas por bacterias raras y resistentes a los antimicrobianos. El análisis de conglomerados reveló una mayor incidencia de muerte, choque séptico, urolitiasis y fragilidad en el grupo de pacientes tratados con carbapenémicos y/o agentes contra el SAMR.

ConclusióN:

El choque séptico se asoció con un alto riesgo de muerte en pacientes mayores con infecciones del tracto urinario, y la urolitiasis se identificó como un factor de riesgo independiente para el desarrollo del choque séptico. La urolitiasis también se asoció con la fragilidad, lo que sugiere que la prevención de la fragilidad podría mejorar indirectamente el pronóstico de los pacientes con choque séptico secundario a infecciones del tracto urinario.

Palabras clave:

Fragilidad Adultos mayores Choque séptico Infecciones del tracto urinario Urolitiasis

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