| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 666.68 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A úlcera péptica perfurada complica-se em 20-50% dos casos, apresentando uma mortalidade de 27%, o que motiva a procura por um factor preditivo preciso que estratifique os doentes. A eosinopénia acompanha a resposta ao stress, inflamação ou infecção aguda. Resulta da sequestração de eosinófilos no local inflamatório e também da supressão da produção e libertação medular.
O objectivo deste trabalho é avaliar a precisão da eosinopénia como marcador de gravidade, a partir do registo de doentes internados no serviço de cirurgia geral do HGO
(2008 a 2013), com diagnóstico de UPP. Definiu-se Eosinopénia como o valor de eosinófilos do sangue periférico inferior a 0,05x109 células/L. Foram incluídos 54 doentes na análise retrospectiva: idade mediana 57 anos; 70,4% homens; 85,4% das perfurações localizadas no duodeno; 72,5% apresentaram eosinopénia; 33,3% apresentaram complicações em que 61,5% foram tratadas medicamente CD1 e CD2.
A eosinopénia mostrou-se bastante limitada como factor preditor de gravidade.
Não se verificaram correlações estatisticamente significativas entre a diminuição da contagem de eosinófilos e o número de complicações, tempo de internamento e mortalidade. A diferença na contagem de eosinófilos, entre os grupos com e sem eosinopénia é apenas estatisticamente significativa para a amílase plasmática (p<0,01).
Neste estudo, a eosinopénia, à admissão na urgência hospitalar, não prevê a severidade da perfuração da UP. A idade e o valor de PCR foram destacados como factores de mau prognóstico em doentes com UPP.
The perforated peptic ulcer (PPU) is complicated in 20-50% of cases, with a mortality of 27%, which motivates the search for an accurate predictor that stratify patients. The eosinopenia accompanies the response to stress, inflammation, or acute infection. Results from the sequestration of eosinophils in the inflammatory site and also from the suppression of the production and bone marrow release. The objective is to evaluate the accuracy of eosinopenia as a marker of severity, from the registry of patients admitted to the general surgery service of HGO (2008-2013), diagnosed with PPU. Eosinopenia was defined as the eosinophils amount in peripheral blood cells below 0,05x109 / L. We included 54 patients in the retrospective analysis: median age 57 years; 70.4% men; 85.4% of the perforations were located in the duodenum; 72.5% had eosinopenia; 33.3% had complications with 61.5% treated medically CD1 and CD2. The eosinopenia proved to be very limited as a predictor of severity factor. There were no statistically significant correlations between decreased eosinophil count and the number of complications, length of hospital stay and mortality. The difference in eosinophil counts between the groups with and without eosinopenia was only statistically significant for the plasmatic amylase (p < 0,01). In this study, eosinopenia, on admission to the hospital emergency does not provide the severity of PPU. The age and the value of RCP were highlighted as poor prognostic factors in patients with PPU.
The perforated peptic ulcer (PPU) is complicated in 20-50% of cases, with a mortality of 27%, which motivates the search for an accurate predictor that stratify patients. The eosinopenia accompanies the response to stress, inflammation, or acute infection. Results from the sequestration of eosinophils in the inflammatory site and also from the suppression of the production and bone marrow release. The objective is to evaluate the accuracy of eosinopenia as a marker of severity, from the registry of patients admitted to the general surgery service of HGO (2008-2013), diagnosed with PPU. Eosinopenia was defined as the eosinophils amount in peripheral blood cells below 0,05x109 / L. We included 54 patients in the retrospective analysis: median age 57 years; 70.4% men; 85.4% of the perforations were located in the duodenum; 72.5% had eosinopenia; 33.3% had complications with 61.5% treated medically CD1 and CD2. The eosinopenia proved to be very limited as a predictor of severity factor. There were no statistically significant correlations between decreased eosinophil count and the number of complications, length of hospital stay and mortality. The difference in eosinophil counts between the groups with and without eosinopenia was only statistically significant for the plasmatic amylase (p < 0,01). In this study, eosinopenia, on admission to the hospital emergency does not provide the severity of PPU. The age and the value of RCP were highlighted as poor prognostic factors in patients with PPU.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Keywords
Úlcera péptica Úlcera péptica perfurada Eosinopénia