Early Prediction of Severe Acute Pancreatitis
Material and methods. The general characteristic of known scoring system assessing the severity of acute pancreatitis: Ranson’s, APACHE-II, Balthazar, Glasgow, Marshall, SOFA, BISAP and HAPS. Author shows the need for early (at hospitalization) recognition of severe acute pancreatitis. Disadvantages of the above scoring systems for prediction of severe acute pancreatitis were considered. Discloses a common technology to create the known systems is to identify the systemic inflammatory response syndrome, or emerging held organ failure. The purpose of this study was to develop simple criteria to quickly and reliably, even in the beginning of the disease difficult to differentiate severe course of acute pancreatitis. To achieve the goal was organized electronic database operated 296 clinic patients with severe acute pancreatitis in 2008–2012, 48 patients died in the hospital without surgery from dire necrotizing pancreatitis. For comparison, the average values of used t-test for independent samples. In cases where the data did not obey the normal distribution used nonparametric U-test of Mann-Whitney. To compare categorical variables used χ2 test and U-test Mann Whitney. Multivariate analysis was performed using stepwise logistic regression for categorical variables and stepwise linear regression for continuous data. Threshold of statistical significance found the generally accepted level p ≤ 0.05. Results with the level of p ≤ 0.01 were considered as statistically significant, and the level of p ≤ 0.001 — as highly significant.
Results and Discussion. As a result of statistical analysis were obtained 15 significant prognostic criteria, confirming a severe course of acute pancreatitis. The proposed system of comparative characterization of specific scores to assess the severity of pancreatitis.
Conclusions. The proposed system of diagnosis of severe acute pancreatitis is simple, specific, economical and reliable in emergency diagnosis of severe acute pancreatitis. Recognized at admission severe acute pancreatitis is an absolute indication for treatment of the patient in the intensive care unit of a specialized surgical department. Traditional scoring systems assess the severity of acute pancreatitis in the relevant specialized ICU for system monitoring of treatment efficacy. Timely intensive therapy of acute pancreatitis provides better efficiency and quality of treatment.
Full Text:PDF (Русский)
A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis / V.K. Singh, B.U. Wu, T.L. Bollen [et al.] // Am. J. Gastroenterol. — 2009. — Vol. 104. — P. 966-71.
Classification of acute pancreatitis — 2012: revision of the Atlanta classification and definitions by international consensus. Acute Pancreatitis Classification Working Group / Р.А. Banks, Т.L. Bollen, С. Dervenis [et al.] // Gut. — 2013. — Vol. 62. — Р. 102-111.
The early prediction of mortality in acute pancreatitis: a large population-based study / B.U. Wu, R.S. Johannes, X. Sun [et al.] // Gut. — 2008. — Vol. 57. — P. 1698-1703.
The Harmless Acute Pancreatitis Score: A Clinical Algorithm for Rapid Initial Stratification of Nonsevere Disease / P.G. Lankish, B. Weber-Dany, K. Hebel [et al.] // Clinical Gastroenterology and hepatology. — 2009. — Vol. 7 — P. 702-705.
Copyright (c) 2016 UKRAINIAN JOURNAL OF SURGERY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019