Predicción de la mortalidad intrahospitalaria mediante el uso de escalas. Servicio de Clínica del Hospital Vicente Corral Moscoso. Cuenca, 2017.

Abstract

INTRODUCTION: Hospital mortality continues to be an important evaluator of the health system. The Sequential Organ Failure Assessment (SOFA) scale and the Charlson Comorbidity Index Modified by Age (ICC) are scales used for predicting hospital mortality.

OBJECTIVE: To determine the predictive value of the SOFA and ICC scales in in-hospital mortality of patients in internal Medicine service of the “Vicente Corral Moscoso” Hospital.

MATERIALS AND METHODS: A descriptive and validity study of scales of patients admitted to the Clinic Service was carried out. It was analyzed with measurements of mean central tendency, standard deviation and frequency tables and percentages. The discriminant power was determined with the ROC curve. RESULTS: The mortality was 14.8%, the most frequent definitive diagnoses associated with mortality were septic shock (21%), pneumonia (17.7%). The SOFA scale at 48 hours had adequate discriminant power, with the highest AUROC of 0.861 with 95% CI: 0.816-0.905, for the cut-off point of 6 with sensitivity of 88.71 and specificity of 89.94 with PPV 60, 44 and VPN 97.87. The Charlson Comorbidity index obtained an AUROC of 0.730, low sensitivity and specificity. The cut-off points for the scales were: SOFA scale at admission 5, SOFA at 48 hours 6 and ICC 4. CONCLUSIONS: The SOFA score measured at admission and at 48 hours constitutes a useful tool for the prediction of hospital mortality in patients of the Clinical Service.