La fragilidad como índice predictor en cirugía de columna
DOI:
https://doi.org/10.31053/1853.0605.v78.n1.30371Palabras clave:
fragilidad, mortalidad, columna vertebral, complicaciones postoperatoriasResumen
Introducción: La fragilidad es un término utilizado para cuantificar la edad fisiológica de los pacientes. Niveles más altos de fragilidad se correlacionan con mayores tasas de complicaciones y mortalidad luego diferentes procedimientos quirúrgicos. El objetivo de este trabajo es evaluar la relación entre la fragilidad y la tasa de complicaciones y mortalidad posterior a cirugías columna electivas dentro de los 90 días.
Material y Métodos: Se realizó un estudio analítico observacional retrospectivo de pacientes mayores de 18 años operados de manera electiva en su columna vertebral. Se analizaron las siguientes variables de manera diferencial según su Índice de Fragilidad modificado (IFm) con punto de corte en 0,18: edad, sexo, índice de masa corporal, score de ASA, detalles de los procedimientos, días de internación, complicaciones, reinternaciones, reoperaciones, y mortalidad dentro de los 90 días postoperatorios.
Resultados: Se incluyeron 257 pacientes. De las 30 complicaciones, 16 ocurrieron en el grupo de los no frágiles (8%) y 14 a pacientes frágiles (24,5%), (p= 0,02). Seis complicaciones fueron infecciosas en el grupo de pacientes frágiles (10,5%) y 4 en los no frágiles (2%), (p= 0,009). No se detectaron diferencias significativas en cuanto a la duración de las cirugías, los días de internación, en la tasa de reoperaciones, reinternaciones ni en la mortalidad.
Conclusión: Los pacientes operados electivamente de columna con un Índice de Fragilidad Modificado ≥0,18 presentaron una probabilidad 3 veces mayor de presentar complicaciones, particularmente infecciosas.
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