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Medicentro Electrónica

versión On-line ISSN 1029-3043

Resumen

RODRIGUEZ-ROJAS, David Alejandro et al. Analysis of prognostic factors in patients with acute pancreatitis. Medicentro Electrónica [online]. 2019, vol.23, n.2, pp.94-104. ISSN 1029-3043.

Introduction:

acute pancreatitis is a very common disease that is defined as a reversible inflammatory process of pancreatic tissue, produced by the intraparenchymal activation of digestive enzymes.

Objective:

to determine the early prognostic factors in acute biliary and non-biliary pancreatitis associated with an unfavorable evolution.

Methods:

an analytical observational study was performed in patients with acute pancreatitis seen at “Arnaldo Milián Castro” Clinico-Surgical University Hospital from 2013 to 2017. Intentional non-probabilistic sampling was used following inclusion and exclusion criteria.

Results:

the average age of the discharged patients and patients with acute non-biliary pancreatitis was significantly lower than the average age of the deceased ones. We identified as risk factors in the occurrence of mortality: age over 65 years (OR = 3.813-CI: 1.451-10.025), female gender (OR = 2.700-CI: 1.044-6.981), biliary pancreatitis (OR = 1.279-CI: 0.321-5.102), acute necrotizing pancreatitis (OR = 7.822-CI: 1.772-34.526), the presence of pleural effusion (OR = 5.929-CI: 1.912-18.386) and a computed tomographic severity index (CTSI)> D (OR = 2.800-CI: 0.381-20.579). The results of the values of sensitivity, specificity, positive and negative predictive value of AST and ALT, in relation to acute necrotizing hemorrhagic pancreatitis, were (37.5%, 69.7%, 23.1% and 82.1%) and (60%, 83.3%, 42.9% and 90.9%), respectively. The area under the curve for ALT was 0.790.

Conclusions:

we identified as negative factors: age over 65, biliary origin, acute necrotizing pancreatitis, pleural effusion and tomographic severity.

Palabras clave : pancreatitis/etiology; predictive value of tests.

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