Morbimortalidad por sepsis por catéter de hemodiálisis en enfermedad renal crónica en mayores de 65 años. Unidad de Cuidados Intensivos del Hospital Teodoro Maldonado Carbo. 2022-2023.

Abstract

Introduction: Chronic kidney disease represents the result of morphological and functional changes induced by an underlying disorder; the most prevalent causes are diabetes mellitus, arterial hypertension, glomerulopathies and polycystic kidney disease. Renal replacement therapy is the alternative of choice to manage this group of patients, being surpassed by kidney transplantation. There are various modalities such as peritoneal dialysis and hemodialysis via central catheter and arteriovenous fistula. One of the most frequent complications of central catheter hemodialysis is infection at the installation site that can subsequently cause bacteremia and a septic condition that, if not diagnosed and treated in time, can lead to the death of the patient. There are risk factors related to the catheter such as installation time, location, time undergoing dialysis, length of hospital stay and the presence of comorbidities that increase the probability of sepsis. Objective: Establish the relationship between the risk factors for sepsis due to hemodialysis catheter and mortality in patients with chronic kidney disease in patients over 65 years of age in the Intensive Care Unit of the Teodoro Maldonado Carbo Hospital. 2022 - 2023. Methodology: Observational, retrospective, cross-sectional and analytical study. The population to be studied were chronic kidney patients over 65 years of age from the ICU area of the database provided by the HTMC. Standard deviation and chi square measurements were used for data analysis. Results: A total of 111 patients were included, of which 70 died from sepsis related to the hemodialysis catheter, the mean age was found to be 75.3 years and the most prevalent sex was male. A significant association was found between the length of hospital stay and the catheter installation time with mortality (p=0.008; p=0.013), respectively. With a mortality rate of 21.08%. Conclusion: In conclusion, the prevalence of sepsis due to hemodialysis catheter is more frequent in males, presenting at an average age of 75 years. The hypothesis proposed in this project is met for the variables hospital stay and catheter installation time. Furthermore, although no significant association was found between the microorganism and the increase in the number of deaths, the bacteria that was predominantly isolated was S. Aureus, followed by S. Epidermidis.