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Advisor(s)
Abstract(s)
Introdução: A pancreatite é uma doença inflamatória do pâncreas, com incidência em
crescendo, causada, entre outros fatores, pela libertação prematura de enzimas digestivas,
que afetam o parênquima pancreático. Os principais fatores etiológicos da Pancreatite
Aguda são os cálculos biliares, e o consumo de álcool, os quais representam respetivamente
cerca 40% de 30 % das incidências. Em Portugal, o consumo de álcool tem vindo a aumentar
sendo um dos países com o consumo mais elevado em todo o mundo.
Objetivos: Estudo de incidência, recorrência e prognóstico de Pancreatite Aguda em
doentes com alcoolismo crónico admitidos no CHUCB, em comparação com o grupo de
controlo (sem variável alcoolismo).
Metodologia: Neste estudo retrospetivo, foram analisados 216 processos clínicos, entre
os quais 105 relativos a Pancreatite Aguda. Os processos clínicos são referentes ao período
entre Janeiro de 2013 e Dezembro de 2018. A análise estatística foi realizada no programa
SPSS Statistics 21 (Statistical Package for the Social Sciences, Inc.,Chicago, IL) da IBM.
Resultados: Dos 216 processos clínicos, 105 correspondiam a doentes que apresentaram
Pancreatite Aguda. Dos 105, apenas 18 tinham historial de alcoolismo crónico, o que
corresponde a 17,1%, sendo na sua maioria do sexo masculino (73.9%). O grupo de estudo
associa-se a um maior número de comorbilidades em comparação com o grupo de controlo,
sendo as principais: hipertensão arterial, dislipidemia, neoplasias e Diabetes Mellitus.
Verificou-se maior recorrência de pancreatite aguda no grupo de estudo (55,6%) apesar de
não ser um valor discrepante. A maior parte dos indivíduos do grupo de estudo são
fumadores (77.8%), contrariamente aos indivíduos do grupo de controlo, em que nenhum
era fumador. O meio complementar de diagnóstico de imagem mais frequentemente
utilizado em ambos os grupos foi a ecografia abdominal. A complicação mais frequente no
grupo de estudo durante o internamento foi o derrame pleural e a ascite. Verificou-se uma
relação positiva entre o índice de massa corporal e o score dos critérios de Ranson e estes
com o tempo de internamento. Apenas se verificou um óbito, de um individuo pertencente
ao grupo de controlo, devido a complicações da Pancreatite Aguda.
Conclusão: A Pancreatite Aguda de etiologia alcoólica apresentou uma incidência mais
reduzida do que o esperado, apesar deste grupo apresentar uma maior taxa de recorrência.
As comorbilidades são mais frequentes nos doentes com histórico de alcoolismo,
constatando-se que praticamente a totalidade destes são fumadores, e pertencem ao sexo
masculino. As complicações mais frequentes durante o internamento foram o derrame pleural e ascite, embora não se tenha verificado nenhum óbito no grupo de estudo. Os scores
dos critérios de Ranson foram diretamente proporcionais ao tempo de internamento assim
como o índice de massa corporal a estes scores, ou seja, podemos concluir que um elevado
índice de massa corporal deverá ser considerado um fator de mau prognóstico.
O exame de imagem mais utilizado para confirmar o diagnóstico é a ecografia abdominal e
o tratamento efetuado na maior parte dos casos foi conservador.
Introduction: Pancreatitis is a pancreatic inflammatory disease, with a growing incidence caused, among other factors, by the premature liberation of digestive enzymes that affect pancreatic parenchyma. Acute Pancreatitis' main etiologic factors are gallstones, alcohol consumption, which incidences represent, respectively, 40 and 30%. In Portugal, alcohol consumption has been increasing, being one of the countries with the highest consumption worldwide. Objective: Study of Acute Pancreatitis' incidence, recurrence and prognosis among patients with chronic alcohol consumption admitted at CHUCB, in comparison with the control group (without the variable alcoholism). Method: In this retrospective study, 216 clinical files were analysed, among which 105 concerning Acute Pancreatitis. The clinical files are referent to the period between January 2013 and December 2018. The statistical analysis was carried out in the SPPS IBM programme Statistics 21 (Statistical Package for the Social Sciences, Inc., Chicago, IL). Results: Of the 216 clinical files, 105 corresponded to patients that presented Acute Pancreatitis. Of the 105, only 18 had a history compatible with chronic alcohol consumption, which corresponded to 17,1%, mostly male (73.9%). The study group was associated with a higher number of comorbidities compared to the control group, the main ones being: arterial hypertension, dyslipidemia, cancer and Diabetes mellitus. There was a greater recurrence of Acute Pancreatitis in the study group (55,6%) despite being a discrepant value. The majority of the study group's individuals are smokers (77.8%), unlike individuals in the control group, in which none were smokers. The most used diagnostic imaging in both groups was the abdominal ultrasound. The most frequent complication among the study group during hospitalization was pleural effusion and ascites. There was a positive association between body mass index and the scores of the Ranson criteria and length of hospitalization. There was only one death, of an individual belonging to the control group, due to Acute Pancreatitis' complications. Conclusion: Acute Pancreatitis of alcoholic aetiology had a lower incidence than expected, although this group had a higher rate of recurrences. Comorbidities are more frequent in patients with a history of alcoholism, and it appears that practically all of them are smokers, and are male. The most frequent complications during hospitalization were pleural effusion and ascites, although there wasn't any death in the study group. The scores of the Ranson criteria were directly proportional to the length of hospitalization as well as the body mass index to these scores, that is, we can conclude that a high body mass index should be considered a factor of poor prognosis. The most used diagnostic imaging technique to confirm the diagnosis is abdominal ultrasound and conservative treatment was performed in most cases.
Introduction: Pancreatitis is a pancreatic inflammatory disease, with a growing incidence caused, among other factors, by the premature liberation of digestive enzymes that affect pancreatic parenchyma. Acute Pancreatitis' main etiologic factors are gallstones, alcohol consumption, which incidences represent, respectively, 40 and 30%. In Portugal, alcohol consumption has been increasing, being one of the countries with the highest consumption worldwide. Objective: Study of Acute Pancreatitis' incidence, recurrence and prognosis among patients with chronic alcohol consumption admitted at CHUCB, in comparison with the control group (without the variable alcoholism). Method: In this retrospective study, 216 clinical files were analysed, among which 105 concerning Acute Pancreatitis. The clinical files are referent to the period between January 2013 and December 2018. The statistical analysis was carried out in the SPPS IBM programme Statistics 21 (Statistical Package for the Social Sciences, Inc., Chicago, IL). Results: Of the 216 clinical files, 105 corresponded to patients that presented Acute Pancreatitis. Of the 105, only 18 had a history compatible with chronic alcohol consumption, which corresponded to 17,1%, mostly male (73.9%). The study group was associated with a higher number of comorbidities compared to the control group, the main ones being: arterial hypertension, dyslipidemia, cancer and Diabetes mellitus. There was a greater recurrence of Acute Pancreatitis in the study group (55,6%) despite being a discrepant value. The majority of the study group's individuals are smokers (77.8%), unlike individuals in the control group, in which none were smokers. The most used diagnostic imaging in both groups was the abdominal ultrasound. The most frequent complication among the study group during hospitalization was pleural effusion and ascites. There was a positive association between body mass index and the scores of the Ranson criteria and length of hospitalization. There was only one death, of an individual belonging to the control group, due to Acute Pancreatitis' complications. Conclusion: Acute Pancreatitis of alcoholic aetiology had a lower incidence than expected, although this group had a higher rate of recurrences. Comorbidities are more frequent in patients with a history of alcoholism, and it appears that practically all of them are smokers, and are male. The most frequent complications during hospitalization were pleural effusion and ascites, although there wasn't any death in the study group. The scores of the Ranson criteria were directly proportional to the length of hospitalization as well as the body mass index to these scores, that is, we can conclude that a high body mass index should be considered a factor of poor prognosis. The most used diagnostic imaging technique to confirm the diagnosis is abdominal ultrasound and conservative treatment was performed in most cases.
Description
Keywords
Alcoolismo Crónico Chucb Fumador Pâncreas Pancreatite Aguda