Nayci Ali Emre, Düzköylü Yiğit, Tatar Cihad, Idiz Ufuk Oğuz, Demircioğlu Mahmut Kaan, Çiçek Mahmut Emin, Yildiz Ishak
General Surgery, Istanbul Training and Research Hospital, Istanbul, TUR.
Gastroenterological Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR.
Cureus. 2022 Dec 31;14(12):e33198. doi: 10.7759/cureus.33198. eCollection 2022 Dec.
Background and aim Acute pancreatitis is a common inflammation of the pancreas which can be severe and even potentially mortal. High rates of mortality showed the importance of immediate identification of patients at high risk and led the clinicians to refer to various scoring systems. Our aim was to investigate a clinical predictive model using the Model for End-Stage Liver Disease-Sodium (MELD-sodium) scoring system, adapting it to acute pancreatitis patients referring to the systemic inflammatory nature of the disease and potential multi-organ failures in severe form. Methods Our multicenter study was designed retrospectively. The medical records were reviewed for the period of two years. Demographics, biochemical results, MELD-sodium scores and mortality rates were analysed. Results MELD-sodium score was found to be statistically correlated with both mortality and the severity of pancreatitis (p<0.001) and significant difference between both mild and severe (p<0.001), moderate and severe groups (p<0.001). Mortality was found to be significantly higher in patients with MELD-Na score when the cut-off value was accepted as '≥11'. Conclusion We found that MELD-sodium score was significantly associated with both severity of disease and mortality rates and also significantly effective between both mild/severe and moderate/severe groups which may be a guide for future multi-center reviews with larger patient and control groups, which can define the potential role of this non-invasive and easy-to-use predictive model in acute pancreatitis patients.
背景与目的 急性胰腺炎是胰腺的一种常见炎症，病情可能严重甚至危及生命。高死亡率凸显了立即识别高危患者的重要性，促使临床医生参考各种评分系统。我们的目的是研究一种使用终末期肝病钠模型（MELD-钠）评分系统的临床预测模型，并根据该疾病的全身炎症性质以及严重形式下潜在的多器官功能衰竭情况，将其应用于急性胰腺炎患者。方法 我们的多中心研究采用回顾性设计。对两年期间的病历进行了审查。分析了人口统计学、生化结果、MELD-钠评分和死亡率。结果 发现MELD-钠评分与死亡率和胰腺炎严重程度均具有统计学相关性（p<0.001），轻度与重度（p<0.001）、中度与重度组之间均存在显著差异（p<0.001）。当将截断值设定为“≥11”时，发现MELD-Na评分患者的死亡率显著更高。结论 我们发现MELD-钠评分与疾病严重程度和死亡率均显著相关，并且在轻度/重度和中度/重度组之间也具有显著效果，这可能为未来更大患者和对照组的多中心综述提供指导，从而确定这种非侵入性且易于使用的预测模型在急性胰腺炎患者中的潜在作用。
