2016, Número 5
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Rev Med Inst Mex Seguro Soc 2016; 54 (5)
Hiperbilirrubinemia como factor predictivo de apendicitis perforada
Alanis-Rivera B, Zuñiga-Vazquez LA, Silva-Escamilla MC
Idioma: Español
Referencias bibliográficas: 38
Paginas: 552-561
Archivo PDF: 322.44 Kb.
RESUMEN
Introducción: en estudios recientes se considera la
hiperbilirrubinemia como un marcador para identificar
la presencia de apendicitis perforada. El objetivo
del estudio es comprobar que la presencia de hiperbilirrubinemia
es un marcador útil para identificar
preoperatoriamente a los pacientes con presencia de
perforación apendicular, y de esta manera proporcionar
un tratamiento oportuno evitando la progresión de
la patología y sus complicaciones.
Métodos: estudio retrospectivo, con 225 pacientes,
los cuales contaban con los criterios de inclusión y
exclusión, del periodo de enero de 2012 a octubre
del 2014 en el HGZ 29 del IMSS, tomando en cuenta
resultados de laboratorio y posquirúrgico, realizando
análisis univariado, bivariado y multivariado.
Resultados: el 56.9% presentó bilirrubina ‹ 1, de los
cuales el 16.4% presentó perforación, mientras que el
de 43.1% con bilirrubina › 1, el 62.88% presentó apendicitis
perforada. La hiperbilirrubinemia incrementa 17
veces más el riesgo de presentar apendicitis perforada
(RMP: 17.63; IC 95%: 6.882-45.207; p ‹ 0.001), lo que
resulta estadísticamente significativo.
Conclusiones: considerando las limitaciones de este
estudio, se puede inferir que la hiperbilirrubinemia está
presente en un mayor número de pacientes con apendicitis
perforada, por lo cual podría ser considerado
como un estudio de laboratorio relevante para incluir
dentro del protocolo de apendicitis, lo cual, a su vez,
puede determinar una mejor planeación para el abordaje
quirúrgico.
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