Corelation among clinical, biochemical and tomographic criteria in order to evaluate the severity in acute pancreatitis
| Autor: | A. E. Serralde-Zúñiga, J. L. Pérez-Hernández, E. G. Durán-Pérez, L. A. Lujano-Nicolás |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Abdominal pain medicine.medical_specialty Adolescent APACHE-II Balthazar Hematocrit Severity of Illness Index Gastroenterology Young Adult Internal medicine medicine Humans Stage (cooking) Ranson criteria Aged Retrospective Studies medicine.diagnostic_test business.industry Hypertriglyceridemia General Medicine Middle Aged medicine.disease Acute pancreatitis Correlation Pancreatitis Ranson Acute Disease Etiology Female medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | Revista Española de Enfermedades Digestivas v.102 n.6 2010 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| ISSN: | 1130-0108 |
| Popis: | Background: the acute pancreatitis is an inflammatory process that may involve peripancreatic tissue and distant organs. According to the Atlanta criteria, in 10 to 20% of the patients the disease is severe. Nowadays there are different clinical and biochemical severity scales such as the Ranson, APACHE-II (Acute Physiology and Chronic Health Evaluation) and hematocrit, which have discrepancies when being compared to tomographic scales such as the Balthazar. There exist few studies that correlate these parameters. Objective: to evaluate the severity of the acute pancreatitis according to the Ranson, APACHE-II and serous hematocrit criteria at the moment of admission of the patient and correlate these scales with the local pancreatic complications according to the Balthazar classification. Patients and method: retrospective, observational and analytic study. There were included patients of any gender above the age of 18, with diagnosis of acute pancreatitis of any etiology, who had performed an abdominal tomography 72 hours after the beginning of the clinical condition in order to stage the pancreatic damage. The diagnosis of acute pancreatitis was established with 2 of the 3 following criteria: a) characteristic abdominal pain; b) uprising of the amylase and/or lipase more than 3 times above the superior normal limit; and c) characteristic finds of acute pancreatitis in the computed tomography. In order to make the correlation, the Pearson or the Spearman tests were used according to the distribution of the variables. Results: there were included 28 patients (21 masculine, 75%). The most frequent etiology was due to alcohol (53.6%, bile (21.4%) and hypertriglyceridemia (17.9%). The age average was 38.1 years old. Fifty per cent of the patients had acute severe pancreatitis according to the Atlanta criteria. Of the patients with APACHE-II less than 8 points, 62.5% were classified according to the Balthazar tomographic scale as D or E degree. Ninety-two point nine per cent of the patients had less than 3 Ranson criteria of which 57.6% got D or E degree. Fifty-seven per cent of the patients with hematocrit value lower than 44% got D and E Balthazar degree, and 64.2% of the patients with hematocrit above 44% got D and E degree. The Pearson correlation (PC) for APACHE-II and Ranson p = 0.013 of 0.476 PC for APACHE-II and Balthazar p = 0.367 of 0.476 and Spearman´s correlation p = 0.460 PC for APACHE-II and hematocrit p = 1.32 of 0.476. Conclusions: there does not exist a good correlation between the seriousness scale of Ranson and APACHE-II with the tomographic Balthazar degrees, therefore it is more likely to find very ill patients with an A or B Balthazar and on the other hand patients with acute low pancreatitis with a D or E Balthazar. |
| Databáze: | OpenAIRE |
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