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2020, Number 2

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Rev Cub Med Int Emerg 2020; 19 (2)

Prognostic indices in predicting acute pancreatitis severity

González AJC, Díaz MRE, Cabrera LJO, Martí GGM

Language: Spanish
References: 18
Page: 1-13
PDF size: 246.47 Kb.


ABSTRACT

Introduction: Several prognostic evaluation systems are used in acute pancreatitis (AP).
Objective: To assess the ability of various prognostic indices to predict acute pancreatitis severity.
Methods: An observational and prospective study was conducted in the Intensive Care Unit at Carlos Manuel de Céspedes General University Hospital, in Granma province, from February 1, 2015 to September 30, 2018, including sixty-four patients with diagnosis of acute pancreatitis. Acute Physiology and Chronic Health Evaluation II and the Bedside index for severity in acute pancreatitis were prognostic indices applied in the first 24 hours at admission; modified Glasgow prognostic index was used at 48 hours. Severity was considered according to the 2012 Atlanta consensus classification. Age, sex, laboratory findings, types and ethology of pancreatitis, and prognostic indices were used as variables. Statistical analysis of correlation between the indices was performed using the receiver operator curve.
Results: There was positive correlation between the indices, but better correlation was observed between the modified Glasgow and the Acute Physiology and Chronic Health Evaluation II (r = 0.811, p = 0.000) prognostic indices. In patients with modified Glasgow 3, the risk of developing severe acute pancreatitis was doubled significantly (RR 1.9 95% CI 1.3 - 2.7 p = 0.000). Similar occurred for the Bedside index for severity in acute pancreatitis ˃2 (RR 1.4 95% CI 1.2 - 1.7, p = 0.008) and the Acute Physiology and Chronic Health Evaluation II ˃8 (RR 1.5 IC 95% 1.5-1.8, p = 0.004). All the indices had good predictability, but the largest area under the operator-receiver curve was the modified Glasgow (0.944 95% CI 0.891 - 0.988).
Conclusions: The Acute Physiology and Chronic Health Evaluation II indices, as well as the Bedside index for severity in acute pancreatitis and Glasgow index had a good ability to predict the severity of acute pancreatitis, nonetheless Glasgow index showed greater predictive value compared to the others.


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