Rev. ecuat. pediatr; 21 (3), 2020
Publication year: 2020
Introducción:
El retraso en búsqueda de atención médica (RBAM) definido como un tiempo
mayor a 48 horas antes de consultar un profesional podría influir en la severidad de las
enfermedades en los niños.
Métodos:
En el presente estudio de cohorte prospectivo, se realizaron entrevistas
estructuradas a tutores de niños que acudieron con fiebre a la emergencia del Hospital Baca
Ortiz, verificando su estado de salud 5 días después, mediante una llamada telefónica. Las
variables incluyeron demográficas, tiempo de atención y gravedad del cuadro. Se utilizó Chi
cuadrado y Riesgo Relativo (RR) para buscar la relación entre dichas variables.
Resultados:
Fueron 304 pacientes ingresados al estudio, 41.1 % presentaron RBAM, cuyas
principales causas fueron la administración de medicación sin receta médica en 48 % y la
falta de detección de signos de alarma en 26.4 %. Los pacientes con RBAM presentaron más
riesgo de requerir hospitalización (RR 1.88 IC 95 % 1.53-2.13 ), cuidados intensivos (RR 2.86 IC
95 % 1.00 8.17), presentar una infección bacteriana severa (RR 2.36 IC 95% 1.81 3.07),
síndrome de respuesta inflamatoria sistémica (RR 2.47 IC 95 % 1.80 3.38), hospitalización al
quinto día posterior a su valoración (RR 2.63 IC 95 % 1.94 3.57) y de mantenerse
hospitalizado por más de 5 días (RR 1.46 IC 95 % 1.15 1.85).
Conclusiones:
El RBAM influye significativamente en la gravedad de los niños con fiebre,
siendo la administración de medicación sin prescripción médica su principal causa
Introduction:
Health careseeking delay, defined as a going to the doctor after more than 48
hours of starting fever, could influence in the severity of the disease.
Methods:
This prospective cohort study recollected the information with a questionnaire who
examined demographic and health features of children younger than 15 years and older of
60 days that went with fever to the emergency room of Baca Ortiz´s Hospital, verifying their
health condition five days after the initial evaluation through a phone call. Bivariate analysis
was made with Chi-square and T student in order to relay these features with health care
seeking delay and severity. Relative risk (RR), was used to measure the association between
health care seeking delay and its consequent severity.
Results:
Of the 304 patients included in the study, 41.1 % had delay in seeking health care
attention. The main causes for this delay were medicine administration without medical
prescription in 48 % and lack of skills in recognizing alarm signs in 25.6 %. The patients who
went to the hospital with delay had more risk of requiring hospitalization, (RR 1.88 CI 95 % 1.53-
2.13 ), intensive care cares (RR 2.86 CI 95 % 1.00 8.17), having a serious bacterial infection (RR
2.36 CI 95 % 1.81 3.07), having SIRS (RR 2.47 CI 95% 1.80 3.38), being hospitalized 5 days
before their initial evaluation in emergency room (RR 2.63 CI 95 % 1.94 3.57) and staying at
the hospital for more than five days (RR 1.46 CI 95 % 1.15 1.85).
Conclusions:
Health care seeking delay has an impact in the severity of the disease of children
with fever. Administration of drugs without medical prescription is the principal reason. Health
public politics should be achieved in order to educate population in these aspects to reduce
morbimortality of children