Tromboembolismo pulmonar agudo intrahospitalario asociado a estancia hospitalaria mayor a un mes en el Hospital General Guasmo Sur durante el periodo de mayo del 2022 a abril del 2023, Guayaquil-Ecuador.

Abstract

Introduction: Pulmonary thromboembolism (PTE) is defined as the thrombotic or embolic obstruction of the pulmonary arterial tree, resulting in a sudden increase in right ventricular afterload and a decrease in left ventricular preload, leading to the development of pulmonary hypertension. It is the third leading cause of cardiovascular mortality worldwide, with an annual incidence of 100-200 per 100,000 inhabitants, causing over 500,000 deaths per year in Europe. However, its epidemiology is complex due to its varied presentation, ranging from clinically silent disease to sudden death. Objective: To correlate prolonged hospital stay with the development of acute pulmonary thromboembolism at General Hospital Guasmo Sur from May 2022 to April 2023. Methods: This was a cross-sectional, retrospective study that used data from the Statistics Department of HGGS in Guayaquil from May 2022 to April 2023. The study included 679 patients diagnosed with pulmonary thromboembolism, of which 153 were selected for analysis. Statistical analysis was performed using IBM SPSS Statistics Version 22, including central tendency and dispersion analysis for quantitative variables and frequency analysis for categorical variables. Chi-square test was used to establish relevance and associations between variables. Results: The mean age of the patients was 65 years, with a standard deviation of 10.2 years and a mode of 63 years. 64.1% of the cases were male, and 35.9% were female. 66% of the patients were overweight, and 4.6% had obesity. Regarding hospital stay, 28.8% stayed for 31-45 days, 66.7% for 46-60 days, and 4.6% for more than 60 days. 64.1% had a history of surgical intervention within 30 days prior to hospital admission. The most prevalent habits were smoking (41.7%) and alcohol consumption (39.4%). Dyspnea was reported in 79.1% of the patients, edema in 35.9%, and tachypnea in 88.9%. The mortality rate was 24.2%, with a significant correlation between the presence of edema and mortality (chi2: 14.565, p<0.001).XV Conclusion: Pulmonary thromboembolism is a disease with high morbidity and mortality, often difficult to detect early. Factors such as age, gender, BMI, hospital stay, surgical history, and habits like smoking and alcohol consumption are associated with the development of pulmonary thromboembolism. Dyspnea and tachypnea are common clinical manifestations, with a significant correlation between edema and mortality. Early detection and management are crucial in reducing mortality rates associated with pulmonary thromboembolism.