Simplified admission criteria for predicting the severity and prognosis of acute pancreatitis
Akut pankreatitin ciddiyetini ve prognozunu tahmin etmek için basitleştirilmiş kabul kriterleri
Anahtar Kelimeler:
Acute pancreatitis- prognosis- simplified admission criteria- BISAP score- APACHE IIÖzet
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.
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