Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Gaziosmanpaşa Training Research Hospital, İstanbul, Turkey.
Department of Emergency Medicine, University of Health Sciences Turkey, Gaziosmanpaşa Training Research Hospital, İstanbul, Turkey.
Medicine (Baltimore). 2024 Apr 26;103(17):e37964. doi: 10.1097/MD.0000000000037964.
To investigate scoring systems and biomarkers for determining the severity and prognosis of acute pancreatitis (AP). Between January and July 2023, 100 patients with AP diagnosed and treated in the emergency department were included. AP was divided into 2 groups according to severity: mild AP and moderately severe AP (MSAP-SAP), according to the revised Atlanta Classification in 2012. Demographic characteristics, severity, intensive care unit (ICU) admission, white blood cell count (WBC), hematocrit, red cell distribution width from whole blood taken at admission and 48 hours later, C-reactive protein (CRP) and biochemistry values, Bedside Index for Severity in Acute Pancreatitis (BISAP), Pancreatitis Activity Scoring System (PASS), and harmless AP score scores were recorded retrospectively. Our variables, which were found to be significant in multiple logistic regression results, were found to increase MSAP-SAP expectation by 4.36-, 7.85-, 6.63 and 5.80 times in the presence of CRP > 47.10, WBC > 13.10, PASS > 0, and necrotizing computed tomography findings, respectively. It was detected that the risk factor which was found significant as a single variable affecting the ICU admission increased the risk of ICU requirement by 28.88 when PASS > 0, by 3.96 when BISAP > 1, and it increased the Atlanta score by 9.93-fold. We found that WBC and CRP values at the time of hospital admission and WBC, CRP, and red cell distribution width values after 48 had the highest accuracy in determining AP disease severity. BISAP, which was found to be significant in determining MSAP-SAP expectations, lost its significance in multiple logistic regression results, and PASS was found to be effective. The PASS is an important score in the clinical evaluation of patients with AP and in determining the need for ICU hospitalization.
探讨用于评估急性胰腺炎（AP）严重程度和预后的评分系统和生物标志物。
回顾性分析 2023 年 1 月至 7 月在急诊科诊断和治疗的 100 例 AP 患者的临床资料。根据 2012 年修订的亚特兰大分类标准，将患者分为轻症胰腺炎（MAP）和中重度胰腺炎（MSAP-SAP）两组。记录患者的一般人口统计学特征、严重程度、入住重症监护病房（ICU）、入院时和入院 48 小时后的白细胞计数（WBC）、红细胞比容、红细胞分布宽度、C 反应蛋白（CRP）和生化指标、床边严重程度指数（BISAP）、胰腺炎活动评分系统（PASS）和无害性胰腺炎评分（HAPS）。多因素逻辑回归分析发现，CRP＞47.10、WBC＞13.10、PASS＞0 和坏死性 CT 表现时，MSAP-SAP 的发生风险分别增加 4.36、7.85、6.63 和 5.80 倍。单因素分析发现，BISAP＞1 时 ICU 入住风险增加 28.88 倍，PASS＞0 时 ICU 入住风险增加 3.96 倍，亚特兰大评分增加 9.93 倍。入院时 WBC 和 CRP 以及入院 48 小时后 WBC、CRP 和红细胞分布宽度值对判断 AP 严重程度的准确性最高。在判断 MSAP-SAP 预期方面有意义的 BISAP 在多因素逻辑回归分析中失去了意义，而 PASS 则是有效的。PASS 是评估 AP 患者病情和确定是否需要 ICU 治疗的重要评分。
