RESUMEN

Antecedentes: Los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) tienen alta prevalencia de insuficiencia cardíaca (IC). Los pacientes con concurrente IC y EPOC tienen peor pronóstico. Sin embargo, el impacto de la insuficiencia cardíaca derecha (ICD) sobre la mortalidad hospitalaria no ha sido explorada. Objetivos: Evaluar la asociación entre la ICD y la mortalidad hospitalaria en pacientes con EPOC. Métodos: Estudio transversal analítico llevado a cabo en pacientes con EPOC hospitalizados. Los pacientes hospitalizados entre el 2014 y 2015 fueron incluidos. Resultados: Noventa y cinco pacientes con diagnóstico de EPOC fueron analizados: EPOC solo (n = 25), EPOC con ICFEp (insuficiencia cardíaca con fracción de expulsión preservada) (n = 29), EPOC e IC (n = 41), y EPOC con ICFEc (insuficiencia cardíaca con fracción de expulsión reducida) (n = 0). Las variables asociadas con riesgo de mortalidad hospitalaria fueron ICD (OR: 10.91, 95% CI: 1.28 a 92.65, p = 0.029), evento cerebrovascular (OR: 14.4, 95% CI: 2.64 a 78.37, p 0.002), tromboembolia pulmonar (OR: 2.09, 95% CI: 2.09 1.47-2.98 ‹ 0.001) y enfermedad renal crónica (OR: 4.08, 95% CI: 3.36 a 7.01, p ‹ 0.001). Conclusión: La ICD es un factor de riesgo independiente para mortalidad hospitalaria en los pacientes con EPOC, que incrementa 9.42 veces.

PALABRAS CLAVE

Insuficiencia cardíaca derecha, pronóstico, enfermedad pulmonar obstructiva crónica, mortalidad hospitalaria, disfunción del ventrículo derecho.

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