Metabolismo en asociación a mortalidad: significado pronóstico de hipoalbuminemia y diabetes mellitus tipo 2 en el paciente hospitalizado con neumonía nosocomial

Abstract

Background: Hypoalbuminemia is associated with the nutritional status of patients with type 2 diabetes mellitus (DM2); it is related to oxidative stress and alterations in lipid and protein metabolism, and is a risk factor for mortality in the critically ill patient. Furthermore, DM2 has been associated with an increase in infection-related mortality. We explored the association of these metabolic conditions with mortality and related factors in patients with nosocomial pneumonia. Methods: We included 120 patients with nosocomial pneumonia in a referral hospital; demographic and clinical data were obtained. Data were compared by χ 2 and logistic regression analysis. Results and conclusions: Mortality of patients with hypoalbuminemia was 50%; 43/46 (91.2%) patients who died had hypoalbuminemia (p = 0.0001). DM2 was present in 59.2% of patients, and was significantly associated with hypoalbuminemia (p < 0.05). Other associated factors were mechanical ventilation (91.7%), higher Candida Score, higher incidence of acute renal failure, and higher requirements of FiO 2. Results showed that low albumin levels were an independent mortality factor.