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Revista de la Facultad de Medicina Humana

English Title

Severity prognostic factors in patients with acute pancreatitis in Hospital Nacional Sergio E. Bernales

Keywords

Pancreatitis, APACHE, Pronóstico

English Keywords

Pancreatitis, APACHE, Prognosis

Abstract

Objetivo: Determinar los factores pronósticos de severidad en pacientes con pancreatitis aguda (PA) en el Hospital Nacional Sergio E. Bernales durante el periodo junio 2016 a junio 2018. Metodología: Estudio de casos y controles, siendo los casos los pacientes con pancreatitis moderada o severa y los controles los de pancreatitis leve. Los datos para las variables evaluadas fueron obtenidos a partir de la revisión de Historias Clínicas. Se usó chi-cuadrado para evaluar la asociación y se hallaron los OR con sus respectivos IC 95%. Se utilizó programa SPSS 25. Resultados: Se revisaron 162 historias clínicas de los cuales 54 (33,3%) pacientes desarrollaron PA moderadamente severa (PAMS) o severa (PAS) y 108 (66.7%) cursaron con PA leve (PAL). De las PAMS y PAS 55,6% fueron hombres; mientras que en las PA leves el sexo femenino fue el predominante con un 91,7 %. La mayoría fue de origen biliar con un 83,3%. Los factores asociados a PAMS/PAS incluyeron tener más de 60 años (OR: 3.10; IC 95%: 1,26-7,65; p= 0.011), presentar derrame pleural (OR: 7,78 IC 95%: 5,745-54,418; p<0.001), hematocrito >40% (OR: 4,17; IC 95%: 2.07-8.39; valor p: <0.001) y puntuación APACHE ≥8 (OR: 7,88; IC 95%: 3.77-16.45; p<0,001). Conclusiones: Los factores asociados a severidad de la pancreatitis fueron la edad, presentar derrame pleural, hematocrito >40% y puntuación APACHE ≥8.

English Abstract

Objective: To determine the prognostic factors of severity in patients with acute pancreatitis (AP) at the Hospital Nacional Sergio E. Bernales during the period June 2016 to June 2018. Methods: Study of cases and controls, being the cases patients with AP moderately severe or severe and controls those of mild AP. The medical records were reviewed to apply the APACHE-II score. Chi- square was used and the ORs were obtained with their respective 95% CI. SPSS 25 program was used. Results: 162 medical records were reviewed. 54 (33.3%) patients developed AP moderately severe or severe and 108 (66.7%) had mild AP. Of the patients with AP moderately severe or severe, 55.6% were men; while in mild AP the female sex was predominant with 91.7%. The majority were of biliary origin (83.3%). There was a predominance of mild AP. AP moderately severe or severe was associated with being over 60 years old (OR: 3.10; 95% CI: 1.26-7.65; p= 0.011), presenting pleural effusion (OR: 7.78 95% CI: 5.745-54.418 ; p <0.001), hematocrit>40% (OR: 4.17; 95% CI: 2.07-8.39; p <0.001) and APACHE score ≥8 (OR: 7.88; 95% CI: 3.77-16.45; p<0.001). Conclusions: The factors associated with the severity of pancreatitis were age, presenting pleural effusion, hematocrit> 40% and APACHE score ≥8.

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