SCORE DE REMS VS CURB 65 COMO PREDICTOR DE MORTALIDAD POR NEUMONIA EN EL SERVICIO DE URGENCIAS, EN EL HOSPITAL GENERAL DR. MANUEL GEA GONZÁLEZ

Abstract

INTRODUCTION: The community-acquired pneumonia is defined as an infection of the lower respiratory tract in an outpatient who is associated with symptoms of acute infection with or without infiltrates on a chest radiograph. The mortality of community-acquired pneumonia is increased according to the presence of comorbidities and age of what is required for a scale forecast to joining the emergency department for a quick diagnosis of the disease as it seeks a assessment scoring system, taking various variables related to critical patient conditions and whose intention is to predict the mortality of it. Several prognostic scores to assess mortality, but few are applicable Score in the emergency department, so it created the REMS Score (Rapid Emergency Medicine Score) which is an abbreviated version of APACHE II includes physiological variables such as frequency heart rate, respiratory rate, blood pressure, temperature, Glasgow Coma Scale and arterial oxygen saturation, and was compared with the CURB score 65. This ratio is called by the acronym CURB of confusion, urea, breath and "blood pressure. so you can compare these scores to determine prognosis of fatal pneumonia in the emergency area of the Hospital General Dr. Manuel Gea González in Mexican patients. 15 OBJECTIVE: To assess whether REMS Score and CURB-65 are predictors of mortality of pneumonia in the emergency department of Hospital General Dr. Manuel Gea González in Mexican patients HYPOTHESIS: REMS scores and CURB-65 in non-surgical patients admitted to the emergency room with a diagnosis of pneumonia, it is expected that the outcome of REMS Score and CURB-65 reporting a mortality equal to that reported in the literature, then its utility will be of prognostic value Mexican patients. DESIGN: A descriptive, open, observational, retrospective, transversal. MATERIAL AND METHODS: We selected 55 cases of patients with pneumonia, admitted to the emergency nonsurgical observation in 2009 and 2010 being selected through a random number table that included patients admitted to the emergency observation adults, both sexes, aged 18 years, complete file with non-surgical conditions, excluding cases with surgical pathology and / or have not been admitted to adult emergency room observation eliminating those cases in which failure to achieve Score collect the components of REMS, Score CURB 65 RESULTS. Since the total REMS patients was 9.91 compared with 4.5 in living with a test value of 10.79 T and a significance with p <.05 and a confidence interval 95% for the REMS of 6.41 to 9.44 in deceased. All this represents a score above 6.48 in the qualification test can be associated with risk of death 16 when the Glasgow Coma Scale and oxygen saturation are outside normal parameters, the CURB 65 is 1.8 points in living and of 2.8 in the deceased. with a test value of 14.88 T and a significance with p <.05 and a confidence interval 95% for the REMS of 2.10 in 2.76 in alive and dead. All this represents a score above 2.10 in the qualification test can be associated with risk of death when the urea and the Glasgow Coma Scale, are outside normal parameters CONCLUSIONS: Our study confirms that the CURB Score Score REMS and 65 can be used in our population to assess the likelihood of mortality, for reasons yet to be elucidated in a future study, the cutoff Score Average total REMS related Mexican patients with a mortality risk of 9.91 points, it is important to note that in our study group the Glasgow Coma Scale and oxygen saturation can be associated with risk of death. and CURB 65 Score average Mexican patients associated with a risk of mortality is 2.8 points, it is important to note that in our study group Urea and Glasgow Coma Scale are outside normal parameters that are significant as independent variables in the risk of death.