IntroductionThe patient in critical condition, regardless of the cause of admission, continues to be a challenge for health systems due to the high mortality that it reports. There is a need to identify some marker of early obtaining, easy to interpret and with high relevance in the prognosis of these patients.ObjectiveTo determine the prognostic value of serum lactate in an Intensive Care Unit (ICU).MethodOne hundred and forty-five patients admitted to an ICU were enrolled in the study. The Acute Physiology and Chronic Health Evaluation II (APACHE) prognosis score, Sequential Organ Failure Assessment, hemodynamic support need, mechanical ventilation, cause of admission, stay in ICU, analytical and physiological variables were determined. The probability of survival of patients who had elevated and normal serum lactate levels was calculated. The risk of dying was determined using the Cox regression model.ResultsTwenty-eight patients died (19%) in the ICU. The serum lactate value was higher in the group of patients with trauma, infections, APACHE II and high creatinine levels; as well as with decreased mean arterial blood pressure, need for hemodynamic support and mechanical ventilation. The survival capacity was higher in patients who had normal serum lactate. Serum lactate was the sole independent predictor of mortality (AHR 1.28 [1.07-1.53], p = 0.008).ConclusionsPatient assessment through the determination of serum lactate levels provides useful information in the initial evaluation of the critical patient.
Introduction: Hospital malnutrition is a global health problem, and its prevalence has been estimated between 30–60%. Its early identification constitutes a pillar of the management and treatment of critically ill patients. Its usefulness has been shown both to improve the survival of these patients, as well as to reduce complications related to it, and reduce costs. Objectives: apply the CONUT scale to assess nutritional risk and as a predictor of mortality. Relate it with causes of admission, stay in the ICU, time on mechanical ventilation, and the state at discharge from the ICU and determine the sensitivity and specificity of the CONUT scale as a predictor of mortality and its comparison with the APACHE II scale. Methods: it was carried out in the ICU of the "Miguel Enríquez" Hospital for a period of 2 years. The variables applied were: age, sex, ICU stay, origin services, need for mechanical ventilation, discharge status, nutritional status classification according to CONUT and APACHE II. Results: There was a predominance of males, the average stay was between 1-6 days, and mortality was low. More than 90% of the patients were malnourished, the diagnosis at admission and the use of mechanical ventilation, and no association with mortality was demonstrated. Conclusions: An association between nutritional status and ICU stay was demonstrated. According to the ROC curve, it was shown that the CONUT has a high sensitivity to predict nutritional risk and its relationship with mortality, compared to the APACHE scale it was low.
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