RESUMO
Introducción: La osteomielitis es un proceso infeccioso óseo. En adultos, presenta alta mortalidad por sus complicaciones sistémicas, influida por factores de riesgos asociados. Por lo anterior el objetivo del estudio es describir la tasa de mortalidad por osteomielitis según sexo, rango etario y región, en el periodo 2016 - 2020 en Chile. Materiales y Métodos: Estudio ecológico de las defunciones por osteomielitis en los años 2016-2020 en Chile, según sexo, grupo etario y región (n=218). Datos obtenidos del departamento de estadística e información en salud. Se calculó tasa de mortalidad. No se requirió aprobación del comité de ética. Resultados: En el periodo estudiado se presentó una tasa de mortalidad de 0,22 x 100.000 habitantes. El sexo masculino presento un 52% de las defunciones en personas de 70 a 89 años, seguido del 25% en los pacientes de 80-89 años de edad. La región que presentó una mayor tasa de mortalidad fué Los Ríos con 0,49. Discusión: Se reportó mayor número de defunciones en grupos etarios avanzados, pudiendo deberse a que es una patología asociada a enfermedades crónicas no transmisibles y en Chile hay gran prevalencia de éstas. La distribución geográfica de la enfermedad evidenció más reportes de defunciones en la zona sur, sin embargo, hay escasas publicaciones que expliquen las posibles causas de ello. Conclusión: Se requieren mayores estudios nacionales para profundizar en los hallazgos encontrados. Es importante conocer más variables sociodemográficas que influyan en la mortalidad por osteomielitis en adultos.
Introduction: Osteomyelitis is a bone infectious process. In the adult stage, it presents a high mortality due to its systemic complications, influenced by associated risk factors. The aim of this work is to describe the mortality rate due to osteomyelitis according to sex, age range, and region, in the period 2016 - 2020 in Chile. Materials and Methods: Ecological study of deaths due to osteomyelitis in the years 2016-2020 in Chile, according to sex, age group, and region (n=218). Data obtained from the Department of Statistics and Health Information. Mortality rate was calculated. Ethics committee approval was not required. Results: During the period studied, the mortality rate was 0.22 per 100,000 inhabitants. The male sex accounted for 52% of deaths in persons between 70 and 89 years of age, followed by 25% in patients between 80 and 89 years of age. The region with the highest mortality rate was Los Ríos with 0.49. Discussion: A greater number of deaths were reported in advanced age groups, which may be due to the fact that it is a pathology associated with chronic non-communicable diseases and in Chile there is a high prevalence of these diseases. The geographical distribution of the disease showed more reports of deaths due to this cause in the south, however there are few publications on possible causes of geographical distribution. Conclusion: Further national studies are required to deepen the findings. It is important to know more sociodemographic variables that influence osteomyelitis mortality in the adult population.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Osteomielite/mortalidade , Osteomielite/epidemiologia , Chile/epidemiologia , Epidemiologia Descritiva , Distribuição por Idade e SexoRESUMO
Mediastinitis is a serious postoperative complication following pediatric cardiac surgery. The objective of this study is to evaluate the cost-effectiveness of surgical treatment for mediastinitis in Guatemala. All children who underwent a median sternotomy and developed postoperative mediastinitis between January 2004 and December 2005 were evaluated. Type of surgical treatment for mediastinitis, hospital outcome, and costs were analyzed. Eighteen (3.3%) of the 535 children who underwent a median sternotomy developed mediastinitis. Two patients underwent debridement of the infected tissues and delayed sternal closure, whereas 16 patients had debridement, primary chest closure, and continuous antibiotic irrigation of the mediastinum. All 11 patients who had the diagnosis of mediastinitis within 2 weeks after the operation survived. Three of the 7 patients (43%) who had delayed diagnosis died (p = 0.0003); all 3 had osteomyelitis (p = 0.0007). Primary closure with antibiotic irrigation was associated to a lower mortality rate and proved less expensive in comparison to delayed sternal closure (p = 0.003) mainly due to the shorter intensive care requirement. Debridement followed by primary closure of the chest and continuous antibiotic irrigation of the mediastinum seems to be a feasible and less expensive method to treat selected cases of postoperative mediastinitis in children.