Crisis epilépticas como factor predictivo de mortalidad en pacientes con hemorragia subaracnoidea aneurismática: un estudio de cohorte retrospectivo
DOI:
https://doi.org/10.59156/revista.v39i02.742Palabras clave:
Epilepsia, Hemorragia subaracnoidea, Mortalidad, Rotura aneurismáticaResumen
Introducción: la hemorragia subaracnoidea (HSA) aneurismática es una condición prevalente, especialmente en regiones como Latinoamérica, con una tasa de mortalidad hospitalaria global del 20%. El 26% de los pacientes con HSA presentan convulsiones, por lo que las guías actuales recomiendan el uso profiláctico de fármacos antiepilépticos (FAEs) en ciertas situaciones.
Objetivos: determinar la presencia de crisis epilépticas y la tasa de mortalidad en pacientes internados con diagnóstico de hemorragia subaracnoidea (HSA) secundaria a rotura aneurismática.
Material y métodos: se realizó un estudio observacional analítico retrospectivo en una cohorte de pacientes internados en nuestra institución con diagnóstico de HSA secundaria a rotura aneurismática, que sufrieron crisis epilépticas durante la internación, y se analizó la tasa de mortalidad asociada en un período de 5 años (2020-2024). Se utilizó IBM SPSS® (v30.0.0) para la estadística descriptiva, prueba de Chi-cuadrado (χ²), prueba T y ANOVA para la comparación de grupos y regresión logística para identificar predictores de la mortalidad.
Resultados: el estudio incluyó a 45 pacientes, con predominio de mujeres (73%), y una edad media de 58 años. El 29% de los pacientes presentó crisis epilépticas durante la internación. La mortalidad global fue del 60%, y aquellos que experimentaron crisis convulsivas tuvieron una tasa de mortalidad significativamente mayor (85% / p = 0.013) en comparación con los que no tuvieron crisis.
Conclusiones: los resultados sugieren una correlación estadísticamente significativa entre la presencia de epilepsia y la mortalidad en pacientes con HSA aneurismática. Aunque estas crisis epilépticas en estos pacientes son relativamente frecuentes, este hallazgo subraya la necesidad de estudios adicionales para identificar factores específicos que contribuyan al aumento de la mortalidad en este contexto clínico.
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