La sepsis es una causa importante de morbilidad y mortalidad pediátrica, especialmente en países de bajos recursos. Los datos sobre la prevalencia regional, las tendencias de mortalidad y su relación con variables socioeconómicas son escasos. Objetivo: determinar la prevalencia regional, mortalidad y situación sociodemográfica en pacientes con diagnóstico de sepsis severa (SS) y shock séptico (ShS) ingresados a Unidades de Cuidado Intensivo Pediátrico (UCIPs). Pacientes y Método:Se incluyeron pacientes de 1 a 216 meses de edad ingresados en 47 UCIPs participantes con diagnóstico de SS o ShS entre el 1 de enero de 2010 y el 31 de diciembre de 2018. Se efectuó análisis secundario de la base de datos del Programa de Benchmarking de Calidad de la Sociedad Argentina de Terapia Intensiva (SATI-Q) para SS y ShS, y revisión de los informes anuales del Ministerio de Salud de Argentina y del Instituto Nacional de Estadística y Censos para los índices sociodemográficos de los años correspon- dientes. Resultados: Se registraron 45.480 ingresos en 47 UCIPs, 3.777 con diagnóstico de SS y ShS. La prevalencia combinada de SS y ShS disminuyó del 9,9% en 2010 al 6,6% en 2018. La mortalidad combinada disminuyó del 34,5% al 23,5%. El análisis multivariado mostró que el Odds ratio (OR) de la asociación entre la mortalidad del SS y el ShS fue de 1,88 (IC 95%: 1,46-2,32) y 2,4 (IC 95%: 2,16- 2,66) respectivamente, ajustada por enfermedad maligna, PIM2 y ventilación mecánica. La prevalen- cia de SS y ShS en diferentes regiones sanitarias (RS) se asoció con el porcentaje de pobreza y la tasa de mortalidad infantil (p < 0,001). Sin embargo, no hubo asociación entre la mortalidad por sepsis y la RS ajustada por PIM2. Conclusiones: La prevalencia y la mortalidad por SS y ShS han disminuido con el tiempo en las UCIP participantes. Las condiciones socioeconómicas más bajas se asociaron con una mayor prevalencia pero con resultados similares de la sepsis.
Covid-19 Latam Datathon was the origin of the present study. Analyzing open databases, it was detected that in Chile the deaths of confirmed Covid-19 cases were concentrated in regions with greatest access to hospitals, which was the opposite of what was detected in other countries of Latin America. The objective was to determine the relationship between the distribution of hospitals and mortality from COVID -19 in Chile. The percentage of confirmed cases from March 2020 to August 2021 was analyzed by regions of the country. The analysis was based on the open database of the Chilean Ministry of Health. Geolocation was used to analyze the distribution of health establishments, confirmed cases and deaths. A positive correlation was observed between mortality and the number of hospitals (R = 0.54, p=0.02).It is known that in large cities there are factors such as the segregation of vulnerable groups and environmental contamination that determine the higher mortality from infectious-contagious diseases. However, in the analyzed database it was not possible to find regional information that would help in the interpretation of the results. The datathon allowed us to glimpse the global need to have open, complete, updated databases, which would make it possible to analyze the variables that determine the causes and prevent the consequences of natural disasters or pandemics such as COVID-19. This will help in the future to reduce analysis biases and to help governments to act promptly in the most vulnerable sites to reduce mortality and economic consequences.
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