Valor del índice plaqueta linfocito como predictor de mortalidad en pacientes con insuficiencia cardiaca descompensada en el Hospital Víctor Lazarte Echegaray
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Date
2024-01-05
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Universidad Nacional de Trujillo
Abstract
La falla cardíaca es un síndrome clínico común y costoso con un aumento significativo en su prevalencia, especialmente en el Reino Unido. Su impacto económico a nivel mundial se estima en 108 millones de dólares anuales, destacándose mayores costos en los últimos tres meses de vida. El diagnóstico temprano es crucial, y los tratamientos farmacológicos, dispositivos y rehabilitación basada en el ejercicio pueden mejorar los resultados, especialmente en casos con fracción de eyección reducida. Sin embargo, la falta de datos contemporáneos en entornos comunitarios limita la comprensión de las tendencias y factores asociados con un peor resultado. Se destaca la necesidad de un marcador pronóstico simple y económico para pacientes con falla cardiaca descompensada, y la relación plaquetas linfocitos (RPL) emerge como un posible indicador. La RPL, un marcador inflamatorio, podría predecir la inflamación y mortalidad. Aunque algunos estudios sugieren su utilidad como factor pronóstico independiente en enfermedades cardiovasculares, la ambigüedad persiste en su papel específico en la insuficiencia cardíaca descompensada. La combinación de un alto recuento de plaquetas y una disminución en el recuento de linfocitos, reflejada en una RPL elevada, podría ser indicativa de resultados adversos. Mecanismos fisiológicos, como el estrés y la respuesta inflamatoria, podrían estar implicados en esta asociación. Es por ello, por lo que se pondrá en investigación la validez del índice plaquetas linfocito como predictor de mortalidad, ofreciendo una perspectiva innovadora, que impactaría en el pronóstico de este grupo de pacientes.
Objetivo: Determinar si el índice de plaqueta linfocito tiene valor predictivo en la mortalidad de pacientes con falla cardiaca descompensada en el HVLE.
Método: Se realizará una investigación analítica, observacional, retrospectivo de pruebas diagnósticas del índice plaqueta linfocitos. Se analizarán los datos e información de pacientes con diagnóstico de falla cardiaca descompensada, atendidos en el Departamento de Medicina del Hospital Víctor Lazarte Echegaray, durante el periodo 2021-2023. Para ello se evaluará, en un total de 196 historias clínicas, la mortalidad a corto plazo, considerando a los pacientes que hayan fallecido a los 30 días de la hospitalización.
Heart failure is a common and costly clinical syndrome with a significant increase in prevalence, particularly in the UK. Its global economic impact is estimated at $108 million annually, with higher costs in the last three months of life. Early diagnosis is crucial, and pharmacological treatments, devices, and exercise-based rehabilitation can improve outcomes, especially in cases with reduced ejection fraction. However, the lack of contemporary data in community settings limits understanding trends and factors associated with poorer outcomes. There is a highlighted need for a simple and economical prognostic marker for patients with decompensated heart failure, and the platelet-lymphocyte ratio (PLR) emerges as a potential indicator. PLR, an inflammatory marker, could predict inflammation and mortality. Although some studies suggest its utility as an independent prognostic factor in cardiovascular diseases, ambiguity persists regarding its specific role in acute heart failure. The combination of a high platelet count and a decrease in lymphocyte count, reflected in an elevated PLR, could indicate adverse outcomes. Physiological mechanisms, such as stress and the inflammatory response, may be involved in this association. Therefore, the validity of the platelet-lymphocyte ratio as a predictor of mortality will be investigated, offering an innovative perspective that could impact the prognosis of this patient group. Objective: To determine if the platelet-lymphocyte ratio has predictive value in the mortality of patients with decompensated heart failure at HVLE. Method: An analytical, observational, retrospective investigation of diagnostic tests for the platelet-lymphocyte ratio will be conducted. Data and information from patients diagnosed with decompensated heart failure, treated in the Department of Medicine at Hospital Víctor Lazarte Echegaray, will be analyzed for the period 2021-2023. A total of 196 medical records will be evaluated for short-term mortality, considering patients who have died within 30 days of hospitalization.
Heart failure is a common and costly clinical syndrome with a significant increase in prevalence, particularly in the UK. Its global economic impact is estimated at $108 million annually, with higher costs in the last three months of life. Early diagnosis is crucial, and pharmacological treatments, devices, and exercise-based rehabilitation can improve outcomes, especially in cases with reduced ejection fraction. However, the lack of contemporary data in community settings limits understanding trends and factors associated with poorer outcomes. There is a highlighted need for a simple and economical prognostic marker for patients with decompensated heart failure, and the platelet-lymphocyte ratio (PLR) emerges as a potential indicator. PLR, an inflammatory marker, could predict inflammation and mortality. Although some studies suggest its utility as an independent prognostic factor in cardiovascular diseases, ambiguity persists regarding its specific role in acute heart failure. The combination of a high platelet count and a decrease in lymphocyte count, reflected in an elevated PLR, could indicate adverse outcomes. Physiological mechanisms, such as stress and the inflammatory response, may be involved in this association. Therefore, the validity of the platelet-lymphocyte ratio as a predictor of mortality will be investigated, offering an innovative perspective that could impact the prognosis of this patient group. Objective: To determine if the platelet-lymphocyte ratio has predictive value in the mortality of patients with decompensated heart failure at HVLE. Method: An analytical, observational, retrospective investigation of diagnostic tests for the platelet-lymphocyte ratio will be conducted. Data and information from patients diagnosed with decompensated heart failure, treated in the Department of Medicine at Hospital Víctor Lazarte Echegaray, will be analyzed for the period 2021-2023. A total of 196 medical records will be evaluated for short-term mortality, considering patients who have died within 30 days of hospitalization.
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Keywords
Plaquetas, Insuficiencia Cardiáca, Linfocitos, Mortalidad