Evaluación de las escalas predictores de severidad de pancreatitis aguda. Revisión sistemática

Abstract

Background: acute pancreatitis (AP) is a very common condition, which can negatively affect the morbidity and mortality of the population, therefore, standardized risk stratification is essential in the timely management of this pathology. General objective: to determine the efficacy of AP severity predictive scales. Methodology: systematic review. Full text articles published in the last five years were included, without language restriction, quantitative methodological designs and quality of evidence categorized in quartile one to four. The research was carried out in databases such as: Cochrane Library Plus, Pubmed, Ebsco, Lilacs, among others. The information was consolidated in personalized tables based on the PICO parameters of the Prism Guide. Results: the Ranson and Bisap scales with a cut-off ≥3, the CTSI ≥4 and the Apache II ≥8, were considered scoring systems with good diagnostic capacity for AP severity according to the area under the curve (AUC) assessment. In the comparison to the Bisap, Ranson and Apache II mortality scales, they showed a good diagnostic value (p <0.05). Regarding pancreatic necrosis, the CTSI was the scale that presented the highest AUC score (p<0.05); in multi-organ failure, Bisap and CTSI maintained high AUC values with a statistically significant relationship (p<0.05). Conclusions: the different scoring scales had a good diagnostic value in predicting AP severity. Limitations: access to scientific articles was limited due to a restricted budget.