Impacto clínico de la pancitopenia en pacientes hospitalizados
Objective: To determine etiology, clinical manifestations, morbidity and mortality, and diagnostic and therapeutic resources used in patients with pancytopenia. Materials and methods: Protocolized, descriptive and observational study of 14 months in patients with pancytopenia defined by hemoglob...
Guardado en:
| Publicado en: | Revista Médica Universitaria |
|---|---|
| Autores principales: | , , , , , |
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=2691 |
| Sumario: | Objective: To determine etiology, clinical manifestations, morbidity and
mortality, and diagnostic and therapeutic resources used in patients with
pancytopenia.
Materials and methods: Protocolized, descriptive and observational study of
14 months in patients with pancytopenia defined by hemoglobin (Hb) <12 g / dL,
platelets <150.000/uL and leukocytes <3.800/uL.
Results: We diagnosed 54 cases of pancytopenia. Prevalence: 22/1000
discharges. Average age: 48.72 years (SD±20.64), 16 (29.63%) were >65 years
and 29 (53.70%) men. The mean hospital stay was 17.13 (SD±13.22) vs 7.25
days (SD±5.4) in the service (p<0.0001). Charlson score: 7.16 (SD±2.96) and
APACHE II score: 12 (SD±5.04). In 45 cases (83.33%; CI95%70.71-92.08) was
secondary to bone marrow involvement; 22 cases (40.74%; CI95%27.57-54.97)
were induced by chemotherapy (15 hematologic neoplasms and 7 solid
tumors), 11 (20.37%; CI95%10.63-33.53) were caused by myeloptisis, 4 cases
(7.41%; CI95%2.06-17.89) by megaloblastosis, 9 cases (16.66%; CI95%7.92-
29.29) by hypersplenism and 9 by infections. Comorbidities were present in
96.29% (CI95%87.25-99.55). The systemic inflammatory response syndrome
(85.19%), anemia (77.8%) and cutaneous purpura (50%) were the most
frequent clinical manifestations. 81.48% presented sepsis (CI95%68,57-90,75)
and 29.63% (CI95%17.98-46.31) had major haemorrhages. Infections occurred
in 81.48% of patients, 50% were nosocomial and 65.91% clinically documented.
34.09% (CI95%20.49-49.92) had microbiological isolation and bacteremia in
29.55% of cases. 51.85% (CI95%37.84-65.66) developed febrile neutropenia
(75% after chemotherapy). 64.81% received blood products and granulocyte -
colony stimulating factors in 46.34% (CI95%32.62-60.39). Crude mortality was
higher than the overall average of the Service (16.66 vs 8.65%) (p = 0.07).-
Conclusions: Pancytopenia in hospitalized patients was characterized as
being mainly secondary to bone marrow involvement, hypersplenism and
infections, associated with prolonged hospitalization, high rates of comorbidity,
infectious complications and higher mortality.
|
|---|
