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Reingresos en una Unidad de Cuidados Intensivos Quirúrgicos: Incidencia y Estratificación de Riesgos para la Atención
Silvia Ramos1,2, Rafael Ramos Fernández1,2, Raul Sevilla1,2
1Department of Anesthesiology and Critical Care, Gregorio Marañón University Hospital, 28007 Madrid, Spain.
Journal of personalized medicine
|December 24, 2025
Resumen
La readmisión no planificada en la unidad de cuidados intensivos quirúrgicos (UR-SICU) afecta al 6,4% de los pacientes, impulsada por la edad, la malignidad y el delirio. Estas readmisiones aumentan significativamente la estancia hospitalaria y el riesgo de mortalidad.
Área de la Ciencia:
- Medicina de Cuidados Críticos
- Resultados Quirúrgicos
- Seguridad del Paciente
Sus antecedentes:
- La readmisión no planificada en la unidad de cuidados intensivos quirúrgicos (UR-SICU) es un evento adverso crítico con implicaciones significativas para la morbilidad del paciente, la duración de la estancia y la mortalidad.
- La investigación existente sobre UR-SICU a menudo se basa en unidades de cuidados intensivos (UCI) mixtas, lo que limita su aplicabilidad directa a cohortes de pacientes quirúrgicos.
Objetivo del estudio:
- Identificar los factores de riesgo independientes asociados con la UR-SICU.
- Evaluar el impacto de la UR-SICU en los resultados de los pacientes, incluida la estancia hospitalaria y la mortalidad.
Principales métodos:
- Se realizó un estudio de cohorte retrospectivo en pacientes adultos ingresados en una unidad de cuidados intensivos quirúrgicos (UCIQ) después de una cirugía no cardíaca entre junio de 2021 y diciembre de 2022.
- Los datos recopilados incluyeron datos demográficos, comorbilidades, puntuaciones de gravedad, tratamientos y complicaciones. Se utilizaron la regresión logística y el análisis de supervivencia de Kaplan-Meier para identificar predictores y evaluar la supervivencia.
Principales resultados:
- De 1361 pacientes, 82 (6,4%) experimentaron UR-SICU. Los predictores independientes de UR-SICU incluyeron edad avanzada, malignidad activa y delirio durante la estancia inicial en la UCI.
- Los pacientes con UR-SICU tuvieron estancias hospitalarias significativamente más largas (46 frente a 13 días) y una mortalidad intrahospitalaria marcadamente mayor (27,1% frente a 1,48%).
- El aumento de la mortalidad persistió a los 6 meses y 1 año para los pacientes con UR-SICU.
Conclusiones:
- La UR-SICU se asocia con factores específicos del paciente y empeora significativamente los resultados del paciente, incluida la hospitalización prolongada y el aumento de la mortalidad a corto y largo plazo.
- La identificación temprana de pacientes de alto riesgo y la implementación de estrategias preventivas personalizadas son cruciales para reducir los eventos evitables de UR-SICU.
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