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Resultados después de fracturas aisladas de costillas en pacientes con enfermedad renal en etapa terminal (ESRD): un

Naveen Balan¹, Anna Huang Perez¹, Henry Olivera Perez¹

¹UCSF Department of Surgery, Highland Hospital, Oakland, CA, USA.

American journal of surgery

|February 10, 2026

Resumen

Los pacientes con enfermedad renal en estadio terminal (ESRD) con fracturas de costillas enfrentan una mayor mortalidad hospitalaria y estancias hospitalarias más largas. Este estudio destaca la ESRD como un factor de riesgo independiente para los peores resultados en pacientes con trauma con fracturas aisladas de costillas.

Área de la Ciencia:

Trauma Cirugía cirugía cirugía.
Nefrología Nefrología.
Medicina de cuidados críticos Medicina de cuidados críticos.

Sus antecedentes:

Las fracturas de costillas son comunes en pacientes con enfermedad renal en etapa terminal (ESRD, por sus siglas en inglés).
La identificación de los factores de riesgo para resultados adversos en pacientes con trauma ESRD es crucial.

Objetivo del estudio:

Investigar los resultados de las fracturas aisladas de costillas en pacientes con ESRD en comparación con pacientes sin ESRD.
Determinar si la ESRD es un predictor independiente de la mortalidad en pacientes traumatizados con fracturas de costillas.

Principales métodos:

Análisis emparejado de propensión del Banco Nacional de Datos de Trauma (NTDB) desde 2021-2023.
Inclusión de pacientes con y sin ESRD con fracturas aisladas de costillas.
El emparejamiento se basa en la demografía, la gravedad de la lesión, el mecanismo del trauma y las comorbilidades.

Principales resultados:

El estudio analizó a 2456 pacientes (edad media de 71 años) con trauma contundente.
La mortalidad hospitalaria fue del 3% para los pacientes con ESRD frente al 1% para los pacientes sin ESRD (p=0,02).
Los pacientes con ESRD experimentaron estancias hospitalarias más largas y se asociaron de manera independiente con un aumento de la mortalidad hospitalaria (OR 1.9, p = 0.04).

Conclusiones:

La enfermedad renal en etapa terminal se asocia con resultados significativamente peores en pacientes con trauma con fracturas aisladas de costillas.
La ESRD es un factor de riesgo independiente para la mortalidad hospitalaria en esta población de pacientes.

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