Resumo

GOMEZ ZULETA, Martín; RUIZ LOBO, Xiomara  e  OTERO REGINO, William. A quick and simple set of indicators for predicting the severity of acute pancreatitis. Rev Col Gastroenterol [online]. 2010, vol.25, n.2, pp.118-127. ISSN 0120-9957.

Acute pancreatitis is an ailment with a high mortality rate. It is essential to discern the probable clinical course of the patient as soon as possible. In the existing literature there are various sets of indicators for use in the attempt to make this prediction, but they are difficult to apply in clinical practice. This encouraged us to create a simpler set of indicators which could be applied from the moment of the patient's admission to the emergency ward. Objective: Evaluate a new set of indicators (hematocrit>44, heart rate>100, and serum glucose level >126 mg/dl). Patients and methods: Prospective study of a cohort of patients selected consecutively after admission to the emergency ward with acute pancreatitis. Clinical findings were taken as predictive variables. Development or absence of development of acute pancreatitis (according to Atlanta criteria) during the patient's hospital stay (until either hospital discharge or death), were taken as end-result variables. Results: 114 patients were eligible for the study. The average age was 53 (range: 18-92), 50 (44%) of the patients were males, 58 (51%) featured Atlanta criteria compatible with severe acute pancreatitis. The mortality rate was 28%. In analyzing the sensitivity of the indicators we found that if at least 2 of the 3 suggested parameters were present upon hospital admission, the probability of acute pancreatitis was greater than 90%. Sensitivity 83%, specificity was 91%, VPP (positive prognosis) was 91%, VPN (negative prognosis) was 84%. Conclusions: This new set of indicators may become very useful in clinical practice as it predicts the severity of pancreatitis in a simple way, is easy to remember, and has parameters that can be checked quickly and which are available in any health institution.

Palavras-chave : Pancreatitis; severity; scales; mortality.

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