Validación de la escala de Montariol modificada como predictor de litiasis de la vía biliar en pacientes de 40 a 60 años en el servicio de emergencia del Hospital Vicente Corral Moscoso. Cuenca, 2019–2020

Abstract

Background: Biliary lithiasis pathology or cholecystolithiasis is a frequent surgical pathology in our environment, with an estimated prevalence of around 29%. Objective: To determine the validity of the modified Montariol scale as a predictor of bile duct lithiasis in patients aged 40 to 60 years at the Vicente Corral Moscoso hospital emergency room. Basin. 2019-2020. Methodological design: Diagnostic test validation study. The sample consisted of 149 patients and it was calculated in Epidat 3.1 with a sensitivity of 88%, specificity of 79% and prevalence of 29%. The results were analyzed in SPSS v.25 and presented in tables of frequencies and percentages; The calculations of the performance indicators of the test were carried out and the ROC curve was presented. Results: The highest frequencies were age 40–50 years (59.1%), mean age 49.1 ± 4.9 years; female gender (64.4%); urban residence (58.4%); secondary schooling (34.9%); Cholangitis (0%). Common bile duct diameter> 6mm (75.2%), stone diameter> 10mm (27.5%), history of jaundice (79.2%); biliary colic (49.0%). The performance indicators were: sensitivity (89.8%), specificity (100.0%), PPV (100.0%), NPV (61.8%), positive likelihood value (indeterminate), negative likelihood value (10.2%), Youden's index (89.8%), Cohen's Kappa index (0.714; p <0.001) and the area under the ROC curve (0.954). Cut-off point at 4.5, with sensitivity of 89.8% and specificity of 100.0%. Conclusions: The Modified Montariol Scale is reliable to be applied in the diagnosis of bile duct lithiasis.