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Adultos con influenza, evolución clínica, costos y
grupos relacionados por el diagnóstico, resultados
de 4 años. Clínica Dávila. Santiago de Chile
César Maquilón O.*, Elizabeth Munster C.**, Cecilia Tapia P.***,
MónicaAntolini T.*, Sebastián Cabrera V.**** y PaulaArpón F.*****
Adults patients with influenza, clinical evolution, cost and diagnosis related groups,
four years results. Clinica Dávila, Santiago, Chile
Introduction
: In 2009 Influenza A H1N1pdm09 caused in Chile 12,258 cases and 155 deaths.
Objective
: To analyze ventilatory support, cost of hospitalization, Diagnosis Related Groups (DRG)
and lethality in adults patients with influenza discharged from our institution, during 2009, 2010, 2012
and 2014.
Patients and Method
: Retrospective descriptive study using electronic medical records.
Results
: 115,673 adults were discharged, 338 (0.29%) with diagnosis of Influenza, age 56.5 ± 22 yr.o.,
59% women, lethality 4%. There were 3 groups, Group 1: without any ventilatory support, 295 patients,
age 63 ± 20, stay 6.6 ± 6.9 days, average cost of hospitalization 2,885,261 clp, medium weight DRG
0.41 (p25 = 0.38) and p75 = 0.62), lethality 1.01% (3 patients). Group 2: Non-invasive mechanical
ventilation (NIMV), 23 cases, age 77.1 ± 13, lethality 22% (5 cases), stay 16.8 ± 12.4, cost 9,245,242
clp, DRG 0.79 (p25 = 0.62 and p75 = 1.03). Group 3: Intubation and invasive mechanical ventilation
(IMV), 20 patients, age 56.4 ± 15, stay 36.9 ± 41.4, cost 38.681.099 clp, DRG 5.86 (p25 = 5.82 and
p75 = 5,86) and lethality 30% (6 patients). The DRG group VMI versus group VMNI and no support
were different (p < 0.0001 and p < 0.0001 respectively). The lethality for influenza in 2014 was 8.5%,
while in 2012, 2010 and 2009 it was 1.5%, 3% and 2.5% respectively. The median age in 2009 was
37.5 yr.o significantly minor, than the other years (p < 0.0001).
Conclusions
: In 2009 the patients were
younger, the need for ventilatory support led to a higher DRG weight, stay, cost and lethality than those
who did not require it.
Key words:
Influenza, Humans; Diagnosis-Related Groups; Hospitalization; Retrospective Studies;
Respiration,Artificial.
Resumen
Introducción:
En 2009 la Influenza A H1N1pdm09 provocó en Chile 12.258 casos y 155 muer-
tes.
Objetivo:
Analizar en adultos egresados de Clínica Dávila con influenza, en 2009, 2010, 2012 y
2014, soporte ventilatorio, costo de hospitalización, Grupos Relacionados por el Diagnóstico (GRD)
y letalidad.
Material y Método:
Estudio descriptivo retrospectivo usando la ficha médica electrónica.
Resultados:
Egresaron 115.673 adultos, 338 (0,29%) con diagnóstico de Influenza, edad 56,5 ± 22
años, 59% mujeres, letalidad 4%. Hubo 3 grupos, Grupo 1: sin ningún soporte ventilatorio, 295 pa-
cientes, edad 63 ± 20, estadía 6,6 ± 6,9 días, costo promedio de hospitalización $2.885.261, mediana
peso GRD 0,41 (p25 = 0,38 y p75 = 0,62), letalidad 1,01% (3 pacientes). Grupo 2: Ventilación mecá-
nica no invasiva (VMNI), 23 casos, edad 77,1 ± 13, letalidad 22% (5 casos), estadía 16,8 ± 12,4, costo
*
Médico, Neumólogo Clínica Dávila. Santiago, Chile.
**
Enfermera, encargada de Registros Clínicos, Clínica Dávila. Santiago, Chile.
***
Médico, Especialista en Laboratorio Clínico, Asesor en Microbiología y Biología Molecular de Clínica Dávila.
Santiago, Chile.
**** Médico, Nefrólogo y PhD en Ciencias Médicas, Clínica Dávila. Santiago, Chile.
***** Ingeniero Comercial, Ingeniero Senior de Estudios en Clínica Dávila. Santiago, Chile.
Rev Chil Enferm Respir 2017; 33: 102-110
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