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Evaluation of diagnostic findings and scoring systems in outcome prediction in acute pancreatitis

机译：急性胰腺炎预后预测中诊断结果和评分系统的评估

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AIM: To determine factors related to disease severity, mortality and morbidity in acute pancreatitis. METHODS: One hundred and ninety-nine consecutive patients were admitted with the diagnosis of acute pancreatitis (AP) in a 5-year period (1998-2002). In a prospective design, demographic data, etiology, mean hospital admission time, clinical, radiological, biochemical findings, treatment modalities, mortality and morbidity were recorded. Endocrine insufficiency was investigated with oral glucose tolerance test. The relations between these parameters, scoring systems (Ranson, Imrie and APACHE Ⅱ) and patients' outcome were determined by using invariable tests and the receiver operating characteristics curve. RESULTS: One hundred patients were men and 99 were women; the mean age was 55 years. Biliary pancreatitis was the most common form, followed by idiopathic pancreatitis (53% and 26%, respectively). Sixty-three patients had severe pancreatitis and 136 had mild disease. Respiratory rate > 20/min, pulse rate > 90/min, increased C-reactive protein (CRP), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) levels, organ necrosis > 30% on computed tomography (CT) and leukocytosis were associated with severe disease. The rate of glucose intolerance, morbidity and mortality were 24.1%, 24.8% and 13.6%, respectively. CRP > 142 mg/L, BUN > 22 mg/dL, LDH > 667 U/L, base excess > -5, CT severity index > 3 and APACHE score > 8 were related to morbidity and mortality. CONCLUSION: APACHE Ⅱ score, LDH, base excess and CT severity index have prognostic value and CRP is a reliable marker for predicting both mortality and morbidity.
机译：目的：确定与急性胰腺炎的疾病严重程度，死亡率和发病率相关的因素。方法：在1998年至2002年的5年中，连续入选了119例诊断为急性胰腺炎的患者。在前瞻性设计中，记录了人口统计学数据，病因，平均入院时间，临床，放射学，生化检查结果，治疗方式，死亡率和发病率。通过口服葡萄糖耐量试验研究内分泌功能不全。这些参数，评分系统（Ranson，Imrie和APACHEⅡ）与患者预后之间的关系通过不变检验和受试者工作特征曲线确定。结果：男性100例，女性99例。平均年龄为55岁。胆源性胰腺炎是最常见的形式，其次是特发性胰腺炎（分别为53％和26％）。严重胰腺炎患者63例，轻度疾病患者136例。呼吸频率> 20 / min，脉搏频率> 90 / min，C反应蛋白（CRP），乳酸脱氢酶（LDH）和天冬氨酸转氨酶（AST）水平升高，在计算机断层扫描（CT）和白细胞增多的情况下，器官坏死> 30％与严重疾病有关。葡萄糖耐受不良率，发病率和死亡率分别为24.1％，24.8％和13.6％。 CRP> 142 mg / L，BUN> 22 mg / dL，LDH> 667 U / L，碱基过量> -5，CT严重性指数> 3，APACHE得分> 8与发病率和死亡率有关。结论：APACHEⅡ评分，LDH，基础过剩和CT严重程度指标具有预后价值，CRP是预测死亡率和发病率的可靠指标。

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