Determinación de predictores de mortalidad en pacientes con tuberculosis (TB)
Resumen
Antecedentes: La tuberculosis es un importante problema de salud pública, sin embargo, no hay investigaciones recientes que documenten factores de riesgo y la relación de estos con la mortalidad y la progresión a formas de tuberculosis resistente.
Objetivos: El presente estudio tiene como objetivos analizar la importancia de los factores de riesgo en la progresión hacia una tuberculosis resistente y determinar si estos mismos son predictores de mortalidad.
Metodología: Se emplearon estudios que determinaron factores predictores de mortalidad por TB (tuberculosis) resistente. Se consultaron las bases MEDLINE, CENTRAL, EBSCO, LILACS y EMBASE, se evaluaron 1152 artículos de los cuales seleccionamos 23 que cumplen con los criterios de selección.
Resultados: Se incluyeron 23 artículos en la revisión. 74% incluyeron pacientes con HIV. La mortalidad mostró heterogeneidad alta en los diferentes estudios revisados y frente a los factores predictores de mortalidad, que incluyen tipo de resistencia, características propias del individuo (modificables y no modificables) y los factores determinados por la enfermedad.
Conclusión: Los predictores de mortalidad en adultos con tuberculosis resistente son los patrones de resistencia, la edad mayor, la coinfección con HIV, el compromiso extrapulmonar, historia de tratamiento previo de la enfermedad, bajo índice de masa corporal o desnutrición, alcoholismo, tabaquismo, cavitación documentada por TAC y comorbilidades.
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