{"id":1908,"date":"2010-10-28T14:28:00","date_gmt":"2010-10-28T19:28:00","guid":{"rendered":"http:\/\/medicinainterna.com.mx\/2010\/10\/28\/criterios-de-gravedad-en-hepatitis-alcoholica"},"modified":"2010-10-28T14:28:00","modified_gmt":"2010-10-28T19:28:00","slug":"criterios-de-gravedad-en-hepatitis-alcoholica","status":"publish","type":"post","link":"https:\/\/medicinainterna.com.mx\/?p=1908","title":{"rendered":"Criterios de gravedad en hepatitis alcoh\u00f3lica"},"content":{"rendered":"\n\n\n\n\n\n
\n

INDICES<\/b><\/p>\n<\/td>\n

\n

FORMULA<\/b><\/p>\n<\/td>\n

\n

MORTALIDAD A 30 DIAS<\/b><\/p>\n<\/td>\n<\/tr>\n

\n

\u00cdndice de discriminaci\u00f3n de Maddrey<\/strong> <\/p>\n

Un resultado mayor a 32 es de mal pronostico e implica una mortalidad mayor a 50%<\/p>\n<\/td>\n

\n

Billirrubina s\u00e9rica (mg\/100 ml) + [4.6 x (tiempo de protrombina del paciente \u2013 tiempo de protrombina del testigo)]<\/p>\n<\/td>\n

\n

Sensibilidad: 98.8% <\/p>\n

Especificidad: 11.7% <\/p>\n

VPP: 61.6% <\/p>\n

VPN: 87.5%<\/p>\n<\/td>\n<\/tr>\n

\n

\u00cdndice de MELD (Mayo end Stage Liver Disease)<\/strong> <\/p>\n

Un valor mayor a 15 considera una hepatitis alcoh\u00f3lica moderada a severa. <\/p>\n<\/td>\n

\n

9.57 loge<\/sup> (creatinina s\u00e9rica mg\/dl) + 3.78 loge<\/sup> (BT mg\/dL) + 11.2 loge<\/sup> (INR) +6.43<\/p>\n<\/td>\n

\n

Sensibilidad: 98.8% <\/p>\n

Especificidad: 0.1% <\/p>\n

VPP: 59% <\/p>\n

VPN: 50%<\/p>\n<\/td>\n<\/tr>\n

\n

Escala de Glasgow<\/strong> <\/p>\n

Un rango entre 5 y 7 predice mortalidad de 7% a 28 dias y 12% a 56 d\u00edas, un rango entre 8 y nueve predice mortalidad de 21% y 33%, un rango entre 10 y 12 se asocia a mortalidad de 67% y 80% respectivamente.<\/p>\n<\/td>\n

\n

Ver siguiente tabla.<\/p>\n<\/td>\n

\n

Sensibilidad: 98.8% <\/p>\n

Especificidad: 61.7% <\/p>\n

VPP: 78.7% <\/p>\n

VPN: 97.4%<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Escala de Glasgow para hepatopat\u00eda alcoh\u00f3lica.<\/strong> <\/p>\n\n\n\n\n\n\n\n\n
\n

Variable<\/b><\/b><\/p>\n<\/td>\n

\n

1 punto<\/b><\/b><\/p>\n<\/td>\n

\n

2 puntos<\/b><\/b><\/p>\n<\/td>\n

\n

3 puntos<\/b><\/b><\/p>\n<\/td>\n<\/tr>\n

\n

Edad (a\u00f1os)<\/p>\n<\/td>\n

\n

<50<\/p>\n<\/td>\n

\n

>50<\/p>\n<\/td>\n

\n

–<\/p>\n<\/td>\n<\/tr>\n

\n

Leucocitos (109\/L)<\/p>\n<\/td>\n

\n

<15<\/p>\n<\/td>\n

\n

>15<\/p>\n<\/td>\n

\n

–<\/p>\n<\/td>\n<\/tr>\n

\n

Urea (mmol\/L)<\/p>\n<\/td>\n

\n

<5<\/p>\n<\/td>\n

\n

>5<\/p>\n<\/td>\n

\n

–<\/p>\n<\/td>\n<\/tr>\n

\n

INR<\/p>\n<\/td>\n

\n

<1.5<\/p>\n<\/td>\n

\n

1.5 \u2013 2.0<\/p>\n<\/td>\n

\n

> 2.0<\/p>\n<\/td>\n<\/tr>\n

\n

Bilirrubina (mcmol\/L)<\/p>\n<\/td>\n

\n

<125<\/p>\n<\/td>\n

\n

125 – 250<\/p>\n<\/td>\n

\n

> 250<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Para convertir urea de mg\/dL a unidades del Sistema Internacional (mmol\/L), se debe multiplicar el valor de urea en mg\/dL por la constant 0.1665. Para convertir bilirrubina de mg\/dL a unidades del Sistema Internacional (mcmol\/L), se debe multiplicar el valor de bilirrubina en mg\/dL por la constante 17.104. <\/p>\n

Fuente: Higuera, M. Perez, J. Serralde, A. et al. Rev Gastroenterol Mex, vol. 75, num. 3, 2010. <\/p>\n

<\/div>\n","protected":false},"excerpt":{"rendered":"

INDICES FORMULA MORTALIDAD A 30 DIAS \u00cdndice de discriminaci\u00f3n de Maddrey Un resultado mayor a 32 es de mal pronostico e implica una mortalidad mayor a 50% Billirrubina s\u00e9rica (mg\/100 ml) + [4.6 x (tiempo de protrombina del paciente \u2013 tiempo de protrombina del testigo)] Sensibilidad: 98.8% Especificidad: 11.7% VPP: 61.6% VPN: 87.5% \u00cdndice de … Continue reading “Criterios de gravedad en hepatitis alcoh\u00f3lica”<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-1908","post","type-post","status-publish","format-standard","hentry","category-gastroenterologia"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts\/1908","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1908"}],"version-history":[{"count":0,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts\/1908\/revisions"}],"wp:attachment":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1908"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1908"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1908"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}