Evaluación nutricional y de laboratorio como predictores de la duración de la estancia hospitalaria, la gravedad de la enfermedad subyacente y la mortalidad en perros
DOI:
https://doi.org/10.5433/1679-0359.2023v44n4p1409Palabras clave:
Perros, Enfermedades Sistémicas, PronóstioResumen
El pronóstico se define en medicina como una predicción basada en el diagnóstico del paciente y las posibilidades terapéuticas, sobre la duración de la enfermedad, la gravedad de la enfermedad y la tasa de mortalidad. Los índices pronósticos utilizados en medicina humana o incluso los pocos estandarizados para medicina veterinaria no están muy extendidos ni aplicados en la clínica de pequeños animales. Por lo tanto, esta investigación tuvo como objetivo identificar variables de uso común en la rutina clínica que puedan ser útiles como marcadores pronósticos, correlacionándose específicamente con la duración de la estadía (IT), la gravedad de la enfermedad y la mortalidad. Para ello, fueron evaluados 246 perros de rutina de un hospital veterinario de enseñanza del sur de Brasil, estudiados en relación al estado nutricional (NS) (por anamnesis, examen físico y de laboratorio), exámenes hematológicos y diversos parámetros bioquímicos séricos. Se calcularon frecuencias, medias y desviaciones estándar de las variables, análisis de correlación y análisis comparativos (Kruskal-Wallis a α = 5%). Se consideraron marcadores relevantes de la gravedad de la enfermedad en perros: presencia de desnutrición, incluidos antecedentes de hiporexia, anorexia, puntuación de condición corporal (BCS) ≤3 y puntuación de masa muscular (MEM≤2); valores bajos de transferrina (TF), capacidad total de unión al hierro (CTLF) y anemia; además de valores elevados de índice de saturación de transferrina (IST), lactato y relación PCR/albúmina. En animales sin enfermedades sistémicas o con enfermedades sistémicas leves a moderadas, los indicadores de TI elevados fueron: valores bajos de albúmina, relación proteína C reactiva (PCR)/albúmina e hiporexia. En animales con enfermedades sistémicas críticas, los indicadores de TI bajos (secundarios a una alta mortalidad) fueron: índice de masa corporal (IMC) y valores de hemoglobina (HB) bajos. Los indicadores de mortalidad en los perros enfermos fueron: hipoalbuminemia y concentración elevada de urea. Se concluye que la observación de estas alteraciones, especialmente cuando ocurren de forma simultánea, apoya la determinación del pronóstico en perros de una población hospitalaria, de forma objetiva, práctica y accesible.
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