RESUMO
INTRODUCTION: There exist contradictory results regarding the role of etiology in severity and mortality of acute pancreatitis. In the population of "Hospital General de México" we stablished their importance. MATERIAL AND METHODS: We carried out a retrospective, comparative, longitudinal, and observational study. We determined sex, age, time of evolution, and subjective nutritional state of patients with diagnosis of acute pancreatitis from January 1, of 1996 to December 31, 2000. We compared days of hospitalization, severity, and mortality according to etiology. RESULTS: Ninety five patients were studied, 54% with biliarY and 41% with alcoholic etiology. Differences did not exist in ages and times of symptom evolution, but did in distribution by sex and nutritional state. There were no differences in days of hospitalization but there were differences in severity and mortality when comparing groups of different etiologies. DISCUSSION: In acute pancreatitis, etiology is the decisive factor of severity and mortality, although this can be conditioned by sex of patient and nutritional state.
Assuntos
Pancreatite Necrosante Aguda/etiologia , Pancreatite Alcoólica/etiologia , Doença Aguda , Adolescente , Adulto , Idoso , Alcoolismo/complicações , Doenças Biliares/complicações , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Pancreatite Necrosante Aguda/mortalidade , Pancreatite Necrosante Aguda/patologia , Pancreatite Alcoólica/mortalidade , Pancreatite Alcoólica/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Taxa de SobrevidaRESUMO
Patients with alcohol-related chronic pancreatitis (ARCP) often have peripheral neuropathy, but no data on the occurrence of autonomic neuropathy (AN) are available for this condition. To assess the autonomic function and the significance of its abnormalities for the prognosis of ARCP, 18 patients with ARCP and associated diabetes mellitus (P-DM group), 10 with ARCP without evidence of diabetes mellitus (P group), 17 patients with insulin-dependent diabetes mellitus (IDDM group), and 18 healthy controls answered a structured questionnaire and underwent three standardized cardiovascular (CV) tests that yielded six different parameters for autonomic nerve function. Patients with at least one symptom plus two abnormal results on CV tests were regarded as having AN. ARCP patients were followed up for 48 months and mortality rates were recorded. The proportions of patients with AN were 66.6% in the P-DM group, 30.0% in the P group, and 29.4% in IDDM patients. Seven of 15 ARCP patients with AN died during follow-up, compared with one of 13 of those without AN (p < 0.037). In conclusion, AN is commonly found in ARCP patients and carries an ominous prognosis.