Características clínicas y epidemiológicas de la pancreatitis aguda en el Centenario Hospital

Abstract

RESUMEN Introducción: La pancreatitis aguda representa un reto diagnóstico en pacientes con dolor abdominal y presenta alta morbilidad, mortalidad y costos hospitalarios en caso de complicaciones. La mayor parte de los datos epidemiológicos de pacientes con PA provienen de otros países. Resulta de utilidad disponer de información de nuestro centro hospitalario. Objetivo: Describir el perfil clínico-epidemiológico de pacientes con pancreatitis aguda en el CHMH durante el período de enero 2008 a diciembre 2012. Metodología: Estudio restrospectivo-descriptivo. Revisión sistemática de expedientes médicos de pacientes con pancreatitis aguda. Resultados: Se incluyeron 70 pacientes. 60% mujeres. Relación hombre/mujer 1:1.5. Edad promedio de 41.8 ± 17.7 años. Grupo etario más afectado 20-49 años. La etiología más común fue: biliar (68.6%), relación hombre/mujer 1:5.6, alcohol (12.9%), hipertrigliceridemia (7.1%). DEIH promedio 10 ± 11 (2-61). Motivo de consulta: dolor, nausea y vómito 54%. 100% tuvo dolor. Factores de riesgo: enfermedad biliar previa (31.4%), tabaquismo (34.3% ), alcoholismo crónico (24.3%), IMC > 25 (71.4%), HTA (15.7%), DM (11.4%), dislipidemia (12.9%). Diagnóstico clínico y confirmación bioquímica (100%). USG anormal (54.5%). Etiología biliar grave fue la mas detectada por Apache II, BISAP, Ranson. Mortalidad general 4.3% principalmente asociada a hipertrigliceridemia, SRIS y falla multiorgánica en hombres. Conclusión: Son necesarios estudios futuros donde se evalúe el impacto clínico de las nuevas recomendaciones internacionales para la clasificación de la gravedad y el tratamiento en base a estas. El abordaje protocolizado y multidisciplinario puede mejorar el pronóstico de los pacientes. Palabras clave: Epidemiología, clínica, clasificación, pancreatitis aguda

ABSTRACT Introduction: Acute pancreatitis represents a diagnostic challenge in patients with abdominal pain and has a high morbidity, mortality and hospital costs in case of complications. Most of the epidemiological data of patients with AP is from other countries. It is useful to have information at our hospital. Objective: To describe the clinical and epidemiological profile of patients with acute pancreatitis in the CHMH during the period from January 2008 to December 2012. Methods: Retrospective-descriptive study. Systematic review of medical records of patients with acute pancreatitis. Results: 70 patients were included. 60% women. Male / female ratio 1:1.5. Average of 41.8 ± 17.7 years old. Most affected age group 20-49 years. The most common etiology was biliary (68.6%), male / female ratio 1:5.6, alcohol (12.9%), hypertriglyceridemia (7.1%). In hospital days stay average of 10 ± 11 (2-61). Complaint: pain, nausea and vomiting 54%. 100% had pain. Risk factors: Biliary disease (31.4%), smoking (34.3%), chronic alcoholism (24.3%), BMI > 25 (71.4%), hypertension (15.7%), DM (11.4%), dyslipidemia (12.9%). Clinical diagnosis and biochemistry confirmation (100%). USG abnormal (54.5%). Severe biliary etiology was more sensed by Apache II, BISAP, Ranson. Overall mortality 4.3% mainly associated with hypertriglyceridemia, SIRS and multiple organ failure in men. Conclusion: Future studies are needed where the clinical impact of new international recommendations for classification of severity and treatment based on these is evaluated. The notarized and multidisciplinary approach may improve the prognosis of patients. Keywords: Epidemiology, clinical classification, acute pancreatitis

ABSTRACT Introduction: Acute pancreatitis represents a diagnostic challenge in patients with abdominal pain and has a high morbidity, mortality and hospital costs in case of complications. Most of the epidemiological data of patients with AP is from other countries. It is useful to have information at our hospital. Objective: To describe the clinical and epidemiological profile of patients with acute pancreatitis in the CHMH during the period from January 2008 to December 2012. Methods: Retrospective-descriptive study. Systematic review of medical records of patients with acute pancreatitis. Results: 70 patients were included. 60% women. Male / female ratio 1:1.5. Average of 41.8 ± 17.7 years old. Most affected age group 20-49 years. The most common etiology was biliary (68.6%), male / female ratio 1:5.6, alcohol (12.9%), hypertriglyceridemia (7.1%). In hospital days stay average of 10 ± 11 (2-61). Complaint: pain, nausea and vomiting 54%. 100% had pain. Risk factors: Biliary disease (31.4%), smoking (34.3%), chronic alcoholism (24.3%), BMI > 25 (71.4%), hypertension (15.7%), DM (11.4%), dyslipidemia (12.9%). Clinical diagnosis and biochemistry confirmation (100%). USG abnormal (54.5%). Severe biliary etiology was more sensed by Apache II, BISAP, Ranson. Overall mortality 4.3% mainly associated with hypertriglyceridemia, SIRS and multiple organ failure in men. Conclusion: Future studies are needed where the clinical impact of new international recommendations for classification of severity and treatment based on these is evaluated. The notarized and multidisciplinary approach may improve the prognosis of patients. Keywords: Epidemiology, clinical classification, acute pancreatitis