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HAPS在预测急性胰腺炎预后中的应用价值。

Utility of HAPS for predicting prognosis in acute pancreatitis.

作者信息

Sayraç Ali Vefa, Cete Yıldıray, Yiğit Özlem, Aydın Alp Giray, Sayrac Neslihan

机构信息

Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2018 Jul;24(4):327-332. doi: 10.5505/tjtes.2017.50794.

Abstract

BACKGROUND

Acute pancreatitis (AP) is a common abdominal disorder, which requires early diagnosis and treatment. Several prognostic scoring systems introduced to clinical practice are not suitable in emergency department (ED) because these require much time and complex parameters. Recently, the harmless acute pancreatitis score (HAPS) has been introduced to identify AP with a nonsevere course. The aim of this study was to determine the utility of HAPS in predicting the severity of AP.

METHODS

All patients aged >16 years who were diagnosed as AP in ED were enrolled in this retrospective study. The study included 144 patients with a mean age of 58.7±15.4 years, and 69 (47.9%) of them were males and 75 (52.1%) were females. Patient data were collected from hospital database. The utility of HAPS was analyzed and compared using the Ranson's score.

RESULTS

HAPS was statistically significant for predicting mild disease (p=0.008) and has demonstrated a specificity of 81%, a positive predictive value (PPV) of 96%, and an odds ratio of 5.57 (1.51-20.50). The predictability of Ranson's scores was not significant. The measure of agreement (κ) between the two scores was 0.15, indicating a low agreement.

CONCLUSION

HAPS is a simple and useful scoring algorithm to predict the non-severe course of AP in ED. HAPS-0 patients did not require early aggressive treatments and advanced radiological screening tools during the early stages of the disease.

摘要

背景

急性胰腺炎(AP)是一种常见的腹部疾病,需要早期诊断和治疗。临床实践中引入的几种预后评分系统在急诊科(ED)并不适用,因为这些系统需要大量时间和复杂的参数。最近,无害急性胰腺炎评分(HAPS)已被引入以识别病程不严重的AP。本研究的目的是确定HAPS在预测AP严重程度方面的效用。

方法

本回顾性研究纳入了所有年龄大于16岁且在ED中被诊断为AP的患者。该研究包括144例患者,平均年龄为58.7±15.4岁,其中69例(47.9%)为男性,75例(52.1%)为女性。患者数据从医院数据库中收集。使用兰森评分分析并比较HAPS的效用。

结果

HAPS在预测轻症疾病方面具有统计学意义(p = 0.008),其特异性为81%,阳性预测值(PPV)为96%,优势比为5.57(1.51 - 20.50)。兰森评分的预测性不显著。两个评分之间的一致性测量值(κ)为0.15,表明一致性较低。

结论

HAPS是一种简单且有用的评分算法,可用于预测ED中AP的非严重病程。HAPS评分为0的患者在疾病早期不需要早期积极治疗和先进的放射学筛查工具。

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