Knowledge acquired from Clinical Guidelines on the Diagnosis and Treatment of Acute Pancreatitis by attending physicians and residents in hospitals in Veracruz

Abstract

Introduction: Clinical practice guidelines on the diagnosis and treatment of acute pancreatitis (CPGDTAP) have been designed in an effort to reduce the morbidity and mortality of that severe disease. Aim: To identify the knowledge acquired from CPGDTAP in hospitals in Veracruz. Materials and methods: A descriptive, observational, multicenter study was conducted at four hospitals in Veracruz, through the application of a survey to evaluate the knowledge of attending physicians and residents that treat patients with acute pancreatitis. Descriptive statistics were employed to analyze the results. Results: A total of 74 physicians were surveyed, 55.41% of whom were attending physicians and 44.59% of whom were resident physicians. The majority of physicians (67.57%) were familiar with CPGDTAP from the Asociación Mexicana de Gastroenterología (AMG), followed by those of the General Health Council of the Mexican Department of Health (CENETEC, the Spanish acronym) (54.05%) and the American College of Gastroenterology (ACG) (48.65%). A total of 97.30% of the physicians routinely use a nasogastric tube, 79.73% considered early enteral nutrition to be very important, as did 98.65% regarding generous fluid replacement, 85.14% did not routinely use antimicrobials, 63.51% ordered a CAT scan at 72 h or later, and 87.84% answered that infected necrosis was the indication for surgery, preferably after the third week. Discussion and conclusions: In our hospital environment, the CPGDTAP issued by the AMG and CENETEC were the most well-known, but their recommended measures were given importance by under 85% of the physicians surveyed. Therefore, the diffusion of the knowledge they contain is advisable to guarantee optimal results in acute pancreatitis management. Resumen: Introducción: Las Guías de Práctica Clínica para el Diagnóstico y Tratamiento de la Pancreatitis Aguda (GPCDMPA) han sido diseñadas con la finalidad de disminuir la morbimortalidad de ésta grave enfermedad. Objetivo: Identificar el conocimiento de las GPCDMPA en hospitales de Veracruz. Material y métodos: Estudio observacional, descriptivo, multicéntrico realizado en 4 hospitales de Veracruz, aplicando encuesta para evaluar su conocimiento en médicos y residentes que atienden pacientes con pancreatitis aguda. El análisis de los resultados se realizó por estadística descriptiva. Resultados: Se aplicaron 74 encuestas: 55.4% a médicos adscritos y 44.59% a residentes. La GPCDTPA más conocida fue la de la Asociación Mexicana de Gastroenterología (AMG) (67.57%), seguida por la del Consejo de Salubridad General de la Secretaría de Salud (CENETEC) (54.05%) y la del Colegio Americano de Gastroenterología (ACG) (48.65%). El 97.30% de los médicos utilizaron rutinariamente una sonda nasogástrica, el 79.73% consideran muy importante el inicio temprano de la nutrición enteral, el 98.65% la reposición hídrica generosa, el 85.14% no emplearon antimicrobianos de rutina, el 63.51% realizan la TAC a partir de las 72 h y el 87.84% consideran que la indicación quirúrgica es la necrosis infectada, preferentemente después de la tercera semana. Discusión y conclusiones: En nuestro medio las (GPCDMPA) más conocidas fueron las de la AMG y CENETEC y su conocimiento es inferior al 85.00%, por lo que es recomendable su difusión para garantizar resultados óptimos en el manejo de la pancreatitis aguda.

Keywords

• Pancreatitis aguda
• Guías de práctica clínica para el diagnóstico y tratamiento
• Conocimiento