Simplified admission criteria for predicting the severity and prognosis of acute pancreatitis
Akut pankreatitin ciddiyetini ve prognozunu tahmin etmek için basitleştirilmiş kabul kriterleri
Keywords:
Acute pancreatitis, prognosis, simplified admission criteria, BISAP score, APACHE IIAbstract
Acute pancreatitis has been recognized since time primeval and has been described as the most terrible of all affliction that occurs in connection with the abdominal viscera. Early diagnosis and accurate staging of disease severity are important aims in the initial assessment and management of acute pancreatitis.
To assess the severity prediction of acute pancreatitis based on the evaluation of simplified entry criteria (Pulse > 100 beats/min, WBC > 14.5 x 103/dl; BUN > 12 mg/dl; RBS > 150 mg/dl.) and compared it with the BISAP and Apache II scores for prediction of acute pancreatitis severity and prognosis.
Patients with acute pancreatitis admitted over a period of 12 months at the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun were the subjects of the study.
The distribution of the study subjects according to the risk assessment of AP concerning Simplified Admission Criteria showed that more than 50% of the cases were at lower risk followed by 37 (38.5%) cases that were at higher risk. According to the APACHE II Score in this study, 57.3% of the total cases were at lower risk while 42.7% were at higher risk. Moreover, according to BISAP Score, 86.5% of the total cases were at lower risk while 13.5% were at higher risk.
A significant association was observed between Simplified admission criteria and the APACHE II Score. Compared with the APACHE II score and BISAP Score, the Simplified admission criteria showed relatable specificity and sensitivity for mortality. A mortality of 7.3% was recorded in the total cases recruited. In this study, results confirmed that Simplified Admission criteria were a useful tool for predicting mortality.
ÖZET
Akut pankreatit ilkel zamanlardan beri bilinmektedir ve karın iç organlarıyla bağlantılı olarak ortaya çıkan tüm rahatsızlıkların en korkunç olanı olarak tanımlanmıştır. Akut pankreatitin ilk değerlendirmesinde ve tedavisinde erken tanı ve hastalık şiddetinin doğru evrelenmesi önemli amaçlardır.
Basitleştirilmiş giriş kriterlerinin (Nabız > 100 atım/dk, WBC > 14,5 x 103/dl; BUN > 12 mg/dl; RBS > 150 mg/dl.) değerlendirilmesine dayalı olarak akut pankreatitin değerlendirilmesi ve şiddet tahmini Akut pankreatit şiddetinin ve prognozunun tahmini için BISAP ve Apache II skorları ile birlikte.
Çalışmaya, Himalaya Tıp Bilimleri Enstitüsü (HIMS), Swami Ram Nagar, Dehradun Cerrahi Bölümü'nde 12 ay boyunca başvuran akut pankreatitli hastalar dahil edildi.
Çalışma deneklerinin AP'nin Basitleştirilmiş Kabul Kriterlerine ilişkin risk değerlendirmesine göre dağılımı, vakaların %50'den fazlasının daha düşük risk altında olduğunu, ardından 37 (%38,5) vakanın daha yüksek risk altında olduğunu gösterdi. Bu çalışmada APACHE II Skoruna göre toplam vakaların %57,3'ü daha düşük, %42,7'si daha yüksek risk altındaydı. Ayrıca BİSAP Skoruna göre toplam vakaların %86,5'i daha düşük, %13,5'i ise daha yüksek risk altındaydı.
Basitleştirilmiş kabul kriterleri ile APACHE II Puanı arasında anlamlı bir ilişki gözlendi. APACHE II skoru ve BISAP Skoru ile karşılaştırıldığında, Basitleştirilmiş kabul kriterleri mortalite için ilişkilendirilebilir özgüllük ve duyarlılık gösterdi. Çalışmaya alınan toplam vakaların %7,3'ünün ölüm oranı kaydedildi. Bu çalışmada sonuçlar, basitleştirilmiş Kabul kriterlerinin ölüm oranını tahmin etmek için yararlı bir araç olduğunu doğruladı.
References
Brivet FG, Emilie D, Galanaud P. Pro- and anti-inflammatory cytokines during acute severe pancreatitis: an early and sustained response, although unpredictable of death. Parisian Study Group on Acute Pancreatitis. Crit Care Med. 1999; 27:749–755.
Farthing M, Roberts SE, Samuel DG, Williams JG, Thorne K, Morrison-Rees S, et al. Survey of digestive health across Europe: final report. Part 1: the burden of gastrointestinal diseases and the organization and delivery of gastroentero-logy services across Europe. United European Gastroenterol J 2014; 2(6):539e43.
Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3): 175–184.
Bakker OJ, Issa Y, van Santvoort HC, Besselink MG, Schepers NJ, Bruno MJ, et al. Treatment options for acute pancreatitis. Nature reviews. Gastroenterol & Hepatol. 2014; 11(8):462–469.
Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology 2007;132:2022–2044.
Yadav D, Timmons L, Benson JT, Dierkhising RA, Chari ST. Incidence, prevalence, and survi-val of chronic pancreatitis: a population-based study. Am J Gastroenterol. 2011 Dec; 106(12):2192–2199
Hamada S, Masamune A, Kikuta K, et al. Na-tionwide epidemiological survey of acute panc-reatitis in Japan. Pancreas 2014;43: 1244–1248.
Deng YY, Wang R, Wu H, Tang CW, Chen XZ. Etiology, clinical management of acute recur-rent pancreatitis. J Dig Dis. 2014; 15(10):570-577.
Tillett WS, Francis T. Serological reactions in pneumonia with a nonprotein somatic fraction of pneumococcus. J Exper Med. 1930;52(4):561–571.
Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
Bradley EL 3rd. A clinically based classification system for acute pancreatitis. In: Summary of the International Symposium on Acute Pancre-atitis, Atlanta, GA, 11–13 September 1992. Arch Surg. 1993;128:586–590.
Wilson C et al: Prediction of the outcome in acute pancreatitis: a comparative study of APACHE II. Clinical assessment and multiple factors scoring systems. Br. J Surg. 1990;77(11):1260-1264.
Ranson JH, Pasternack BS. Statistical methods for quantifying the severity of clinical acute pancreatitis. J Surg Res. 1977;22:79–91.
Imrie CW, Benjamin IS, Ferguson JC, et al. A single-centerdoubleblind trial of Trasylol the-rapy in primary acute pancreatitis. Br J Surg. 1978;65: 337–341.
McKay CJ, Evans S, Sinclair M, et al. High early mortality rate from acute pancreatitis in Scot-land, 1984-1995. Br J Surg. 1999;86: 1302–1305.
Blamey SL, Imrie CW, O’Neill J, et al. Prognos-tic factors in acute pancreatitis. Gut 1984;25:1340–1346.
Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818–829.
Singh VK, Wu BU, Bollen TL, et al. Early sys-temic inflammatory response syndrome is asso-ciated with severe acute pancreatitis. Clin Gast-roenterol Hepatol. 2009;7:1247–1251.
Brown A, James-Stevenson T, Dyson T, et al. The Panc 3 score: a rapid and accurate test for predicting severity on presentation in acute pancreatitis. J Clin Gastroenterol. 2007;41:855–858.
Harrison DA, D’Amico G, Singer M. The Panc-reatitis Outcome Prediction (POP) Score: a new prognostic index for patients with severe acute pancreatitis. Crit Care Med. 2007;35:1703–1708.
Singh VK, Wu BU, Bollen TL, et al. A prospecti-ve evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol. 2009;104:966–971.
Ogawa M, Hirota M, Hayakawa T, et al. Deve-lopment and use of a new staging system for severe acute pancreatitis based on a nationwide survey in Japan. Pancreas 2002; 25:325–330
Banks PA, Freeman ML, Practice Parameters Committee of the American College of Gastro-enterology. Practice guidelines in acute pancrea-titis. Am J Gastroenterol 2006; 101:2379.
Balthazar EJ, Freeny PC, van Sonnenberg E. Imaging and intervention in acute pancreatitis. Radiology 1994;193:297–306.
Williamson RCN. Early assessment to severity in acute pancreatitis. Gut 1984;25:1131-1139.
Harshit Kumar and M. Singh Griwan. A compa-rison of APACHE II, BISAP, Ranson’s score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised At-lanta Classification. Gastroent Report 20186(2);127–131.
Gonzálvez- Gasch et al. A simple prognostic score for risk assessment in patientswith acute pancreatitis. Eur J Int Med. 2009;2:e43–e48.
Roberts SE, Akbari A, Thorne K, Atkinson M, Evans PA. The incidence of acute pancreatitis: impact of social deprivation, alcohol consump-tion, seasonal and demographic factors. Ali-ment Pharmacol Ther. 2013; 38(5):539-548.
Khanna AK, Meher S, Prakash S, et al. Compa-rison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE II, CTSI Scores, IL-6, CRP and Pro-calcitonin in predicting severity, organ failure, pancreatic necrosis, and mortality in acute pancreatitis. HPB Surg. 2013;2013:367581.
Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut 2008;57(12):1698-1703.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 JOURNAL OF SURGICAL ARTS / Cerrahi Sanatlar Dergisi
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
