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Vojnosanitetski pregled
2017, vol. 74, br. 9, str. 821-830
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP160227100S

Creative Commons License 4.0
Klinički i laboratorijski parametri povezani sa smrtnim ishodom kod akutnog pankreatitisa
aClinical Center Kragujevac, Clinic for General and Thoracic Surgery, Kragujevac + University of Kragujevac, Faculty of Medical Sciences, Kragujevac
bUniverzitet u Kragujevcu, Medicinski fakultet

e-adresa: sstefanovic@medf.kg.ac.rs

Projekat

Farmakološka analiza efekata biološki aktivnih supstanci na izolovane glatke mišice gastrointestinalnog i urogenitalnog trakta coveka (MPNTR - 175007)
Project of the Macro project, No JP 13-11: The analysis of factors that contribute to complications and/or death of acute pancreatitis in patients treated inintensive care unit

Sažetak

Uvod/Cilj. Akutni pankreatitis je zapaljenska bolest koja je u slučaju ispoljavanja teških oblika bolesti povezana sa visokom stopom smrtnosti. Cilj ove studije bio je da ispita faktore za koje postoje oprečni literaturni podaci o povezanosti sa povećanom smrtnošću kod bolelsnika sa akutnim pankreatitisom, kao i one faktore koji prethodno nisu dovoljno ispitivani. Metode. Ova prospektivna kohortna studija sa usađenom studijom tipa slučaj/ kontrola, obuhvatila je sve bolesnike lečene zbog akutnog pankreatitisa u Kliničkom centru Kragujevac, Srbija, tokom trogodišnjeg perioda (od oktobra 2011. do decembra 2014. godine). Slučajevi (n = 19) bili su bolesnici koji su umrli, dok su kontrolnu grupu (n = 113) činili bolesnici kod kojih nije zabeležen smrtni ishod. Povezanost između pretpostavljenih faktora rizika i opserviranog ishoda ispitivana je pomoću univarijante i multivarijantne logističke regresione analize, a rezultati su prikazani vrednostima sirovog i korigovanog unakrsnog odnosa šansi (odds ratio - OR) sa pripadajućim 95% intervalom poverenja (confidence interval - CI). Rezultati. Značajna povezanost sa smrtnim ishodom kod akutnog pankreatitisa nađena je za starije životno doba bolesnika (korigovani OR 1,12, 95%CI 1,02-1,23), prisustvo značajnog komorbiditeta (korigovani OR 10,62, 95%CI 1,01-111,39), povišene vrednosti interleukina (IL)-8 trećeg dana od početka bolesti (korigovani OR 1,05 95%CI 1,02, 1,08), primenu tramadola i/ili morfina (korigovani OR 47,34, 95%CI 3,21-699,08), Bedside index for severity in acute pancreatitis (BISAP) skor ≥ 3 u prvih 24 sata (korigovani OR 48,11, 95%CI 3,14-736,29), kao i za profilaktičku primenu antibiotika (korigovani OR 0,07, 95%CI 0,01-0,85). Zaključak. Starije životno doba, značajan komorbiditet, primena tramadola i/ili morfina i teži oblik bolesti procenjen BISAP skorom mogu povećati rizik od nastanka smrtnog ishoda kod bolesnika sa akutnim pankreatitisom, dok profilaktička primena antibiotika može imati zaštitnu ulogu.

Ključne reči

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