Modelo matemático predictivo de mortalidad por neumonía adquirida en la comunidad

Pedro Julio García Álvarez, Ángel Pastor García Albero, Jorge Santana Álvarez

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Fundamento: la neumonía adquirida en la comunidad constituye un importante problema de salud a nivel global. En el país es la cuarta causa de muerte. Los índices pronósticos ayudan a detectar de manera temprana los pacientes de alto riesgo, pero estos tienen baja sensibilidad y especificidad.
Objetivo:
proponer un modelo matemático predictivo de mortalidad de la neumonía adquirida en la comunidad.
Métodos:
se realizó un estudio analítico longitudinal con dos grupos, se efectuó la prueba de Mann Withney para obtener variables predictivas de mortalidad. Se calculó correlación de Pearson a las variables con significación, luego se elaboró el modelo matemático y se llevó a la curva ROC para encontrar el área de la curva así como las coordenadas del punto de corte. Se hizo cálculo de sensibilidad y especificidad.
Resultados:
edad de 79 ± 11 años con 50 % femeninas. La mortalidad global estuvo en el orden del 35 %. Las variables con diferencias de comportamiento entre los dos grupos fueron la presión arterial sistólica (x2=0,001), así como la presión arterial diastólica (x2=0,001). El valor de la creatinina se comportó con (x2=0,03). La frecuencia respiratoria de (x2=0,01). La presión de oxigeno de (x2=0,036) al igual que las cifras de hemoglobina, por último el nivel de potasio (K) (x2=0,004) con marcada diferencia entre los grupos.
Conclusiones: este modelo matemático es una herramienta útil a pie de cama del paciente ya que ayuda a dar un pronóstico más acertado y además por la elevada especificidad ayuda a corroborar el juicio clínico.
DeCS: NEUMONÍA; MODELOS MATEMÁTICOS; SENSIBILIDAD Y ESPECIFICIDAD; CAUSALIDAD; ESTUDIOS LONGITUDINALES.

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