Evaluation of six scoring systems and four laboratory tests in the prognostic assessment of severe acute pancreatitis
10.3760/cma.j.issn.0254-1432.2018.10.005
- VernacularTitle:6种评分系统和4个实验室检查指标对重症急性胰腺炎预后的评估作用
- Author:
Man LI
1
;
Xiaokang XING
;
Feng GUO
Author Information
1. 浙江大学医学院附属邵逸夫医院危重医学科
- Keywords:
Severe acute pancreatitis;
pancreatitis of outcome prediction;
Ranson score;
BISAP;
APACHE Ⅱ;
systemic inflammatory response syndrome;
Glasgow;
ROC curve
- From:
Chinese Journal of Digestion
2018;38(10):673-677
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the six scoring systems and four laboratory tests,including pancreatitis outcome prediction (POP),Ranson score,bedside index for severity in acute pancreatitis (BISAP),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),systemic inflammatory response syndrome (SIRS),and Glasgow score as well as four laboratory tests including C-reactive protein (CRP),hematocrit (HCT),blood urea nitrogen (BUN) and serum creatinine (Scr) in the prognostic assessment of severe acute pancreatitis (SAP).Methods From January 2016 to December 2017,at Sir Run Run Shaw Hospital,151 SAP patients who met the enrollment criteria were retrospectively analyzed.According to the time from onset to treatment,the patients were divided into less than three days group (n=102) and over three days group (n=49).The evaluation of six scoring systems and four laboratory tests,including CRP,HCT,BUN and Scr at 0,24 and 48 h after hospitalization in the prognostic assessment of SAP patients was measured by receiver-operating characteristic (ROC) curve.Results The Ranson score had the highest area under curve (AUC) value (0.916) in the evaluation of the prognosis of SAP patients less than three days group followed by BISAP,APACHE Ⅱ,Glasgow and POP score,and their AUC values were 0.832,0.823,0.793,and 0.787,respectively,all of them were statistically significant in the prognostic assessment of SAP patients in less than three days group (all P＜0.05).There were statistically significant of BISAP and APACHE Ⅱ scores in the prognostic evaluation of SAP patients in over three days group (both P＜0.05),and the AUC values were 0.751 and 0.735,respectively,which were less than those of SAP patients in less than three days group.There were statistical significance of BUN and Scr at 24 and 48 h after hospitalization in the prognostic assessment of SAP patients in less than three days group (all P＜0.05),and the AUC values were 0.856,0.853 and 0.793,0.874,respectively.There were statistical significance of BUN at 0,24,48 h and Scr at 48 h after hospitalization in the prognostic assessment of SAP patients in over three days group (all P＜0.05),and the AUC value was 0.709,0.754,0.742 and 0.716,respectively.Conclusions Ranson,POP and Glascow score systems are only suitable for patients with SAP less than three days.APACHE Ⅱ,BISAP score systems,BUN and Scr can be used to evaluate patients with SAP over three days,but are more suitable for patients with SAP less than three days group.
