Validez del índice plaqueta/linfocito comparado con el índice neutrófilo/linfocito en la predicción de pancreatitis aguda severa

Abstract

Demostrar la mayor validez del índice plaqueta/linfocito comparado con el índice neutrófilo/linfocito en la predicción de pancreatitis aguda severa. Material y método: Estudio analítico, observacional, de pruebas diagnósticas, donde se evaluó 440 historias clínicas de pacientes con pancreatitis aguda que cumplieron con los criterios de selección, los cuales fueron separados en dos grupos, severos y no severos. El grupo de pacientes no severos estuvo conformado por pacientes con pancreatitis leve y moderadamente severa. Se calculó el área bajo la curva ROC con el punto de corte ideal, la sensibilidad, especificidad, VPP y VPN. Resultados: De los 440 pacientes con diagnóstico de pancreatitis aguda 401 (91.1%) no severos y 39 (8.9%) severos. El IPL tuvo un área bajo la curva de 0.954 (IC95% 0.916-0.992) con un punto de corte para pancreatitis aguda severa de 426 (S: 87%, E: 93%, VPP: 54.8% y VPN: 98.7%). El INL tuvo un área bajo la curva de 0.981 (IC95% 0.965-0.997) con un punto de corte de 15.5 (S: 97.4%, E: 86.8%, VPP: 41.8% y VPN: 99.7%). Al comparar ambos índices no se observó una diferencia estadísticamente significativa entre ambos (p>0.05). El hematocrito y el BUN están asociados significativamente a pancreatitis aguda severa (p<0.05). Conclusiones: El índice plaqueta/linfocito y neutrófilo/linfocito tienen igual validez en la predicción de pancreatitis aguda severa.

To demonstrate the greater validity of the platelet/lymphocyte ratio compared to the neutrophil/lymphocyte ratio in the prediction of severe acute pancreatitis. Material and method: Analytical, observational study of diagnostic tests, where 440 medical records of patients with acute pancreatitis who met the selection criteria were evaluated, which were separated into two groups, severe and non-severe. In the group of non-severe patients, patients with mild and moderately severe pancreatitis were included. The area under the ROC curve was calculated with the ideal cut-off point, sensitivity, specificity, PPV and NPV. Results: Of the 440 patients diagnosed with acute pancreatitis, 401 (91.1%) were non-severe and 39 (8.9%) severe. The LPI had an area under the curve of 0.954 (95% CI 0.916-0.992) with a cut-off point for severe acute pancreatitis of 426 (S: 87%, E: 93%, PPV: 54.8% and NPV: 98.7%). The INL had an area under the curve of 0.981 (95% CI 0.965-0.997) with a cut-off point of 15.5 (S: 97.4%, E: 86.8%, PPV: 41.8% and NPV: 99.7%). When comparing both indices, no statistically significant difference was observed between them (p>0.05). Hematocrit and BUN are significantly associated with severe acute pancreatitis (p<0.05). Conclusions: The platelet/lymphocyte and neutrophil/lymphocyte ratios are equally valid in predicting severe acute pancreatitis.