Álvarez Jorge, Castro Pablo, Fernández Maria, Mcmullen Beatriz, Rodríguez Carmen, Vera Jorge
Bol Asoc Med P R. 2015 Jan-Mar;107(1):33-7.
The purpose of this study was to estimate the degree of association between clinical (Ranson criteria) and radiological variables (Abdominal CT scan) with degree of severity in patients with a diagnosis of acute pancreatitis.
All patients discharged with the diagnosis of acute pancreatitis from January 1, 2010 through December 31, 2012 in a community hospital were selected (N=174). The following variables were studied: sex; age; weight; height; admission and discharge dates; presence of several chronic conditions; laboratory results included in Ranson criteria; abdominal CT category; outcome, including fatality surgery, and other complications. Analysis included descriptive statistics and Risk-Ratios for complications for different groups of subjects, using clinical and radiological criteria.
The incidence rate of complications, including fatality, surgery and organ failure was 36.2%. Factors that showed significant associations with the risk of complication on crude analysis were gallbladder disease with a RR=1.78 ($95% CI: 1.22, 2.60) and abnormal abdominal CT with a RR=1.85 (95% CI: 1.11, 3.07). with multivariate analysis, gallbladder disease, abnormal abdominal CT, and presence of 3 or more Ranson's criteria showed increased risk for complications, but the results did not reach statistical significance.
The factors that seemed to be associated with increased rate of complications in subjects with acute pancreatitis were gallbladder disease, abnormal abdominal CT, and 3 or more Ranson's criteria. The Results did not show statistical significance probably because of low statistical power of the study.
本研究的目的是评估临床(兰森标准)和放射学变量(腹部CT扫描)与诊断为急性胰腺炎患者的严重程度之间的关联程度。
选取2010年1月1日至2012年12月31日在一家社区医院出院诊断为急性胰腺炎的所有患者(N = 174)。研究了以下变量:性别、年龄、体重、身高、入院和出院日期、几种慢性病的存在情况、兰森标准中包含的实验室结果、腹部CT分类、结局,包括死亡、手术及其他并发症。分析包括描述性统计以及使用临床和放射学标准对不同受试者组并发症的风险比。
包括死亡、手术和器官衰竭在内的并发症发生率为36.2%。在粗分析中显示与并发症风险有显著关联的因素是胆囊疾病,风险比RR = 1.78(95%可信区间:1.22, 2.60)以及腹部CT异常,风险比RR = 1.85(95%可信区间:1.11, 3.07)。经多变量分析,胆囊疾病、腹部CT异常以及存在3项或更多兰森标准显示并发症风险增加,但结果未达到统计学显著性。
在急性胰腺炎患者中似乎与并发症发生率增加相关的因素是胆囊疾病、腹部CT异常以及3项或更多兰森标准。结果未显示统计学显著性可能是因为研究的统计效能较低。