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Revista de la Facultad de Medicina Humana

English Title

Comparison of the APACHE II and BISAP scales in the prognosis of acute pancreatitis in a hospital of Peru

Keywords

Pancreatitis aguda, Falla de órganos

English Keywords

Acute pancreatitis, Organ failure

Abstract

Introducción: La pancreatitis aguda continúa siendo una enfermedad con morbilidad y mortalidad significativas. Se diagnostica mediante criterios clínicos y el proceso inflamatorio puede llegar hasta una falla de órganos. El objetivo del presente estudio fue comparar las escalas de APACHE II y BISAP en el desarrollo de falla orgánica en pacientes con pancreatitis aguda de un hospital público del Perú. Pacientes y métodos: Se realizó un estudio de validación de prueba diagnóstica. Se evaluaron las historias clínicas de pacientes que estuvieron hospitalizados con el diagnostico de pancreatitis aguda en el servicio de Medicina Interna y la Unidad de Cuidados Intensivos. Se aplicó las escalas APACHE II y BISAP, se calculó la curva ROC, sensibilidad, especificidad, valor predictivo positivo y negativo. Para el análisis estadístico se utilizó el SPSSv23. Resultados: Se evaluaron 146 historias de pacientes que cumplían con los criterios de inclusión. Se obtuvo un área bajo la curva de 0.957 para BISAP y 0.996 para APACHE II; con una sensibilidad y especificidad para APACHE II de 83% y 99%, para BISAP de 66% y 99%. El valor predictivo positivo y negativo para APACHE II es 83% and 99% y para BISAP 80% y 98%. Conclusiones: La escala de APACHE II fue superior para detectar falla de órganos. Se determinó que ambas escalas poseen alta especificidad, siendo mayor la sensibilidad en la escala BISAP.

English Abstract

Introduction: Acute pancreatitis continue to be a disease with significant morbidity and mortality. It is diagnosed by clinical criteria and the inflammatory process can lead to organ failure. The objective of the present study was to compare the scales of APACHE II and BISAP in the development of organic failure in acute pancreatitis from a public hospital of Perú. Pacients and methods: An analytical from validation of a diagnostic test. There were clinical records of patients who were hospitalized with the diagnosis of acute pancreatitis in the Internal Medicine service and the Intensive Care Unit were evaluated. The APACHE II and BISAP scales were applied and the ROC curve, the sensitivity, the specificity, the positive and negative predictive value was calculated for each one. SPSSv23 was used for statistical analysis. Results: Were reviewed 146 stories that met the inclusion criteria. An area under the curve of 0.957 was obtained for BISAP and 0.996 for APACHE II; with a sensitivity and specificity for APACHE II of 83% and 99%, for BISAP of 66% and 99%. In addition, the positive and negative predictive value for APACHE II is 83% and 99% , for BISAP 80% and 98% . Conclusion: The APACHE II scale was superior for detecting organ failure. It was determined that both scales have high specificity, however the APACHE II scale presented a higher sensitivity than the BISAP scale.

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