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Comparison of Scoring Systems in Predicting Severity and Prognosis of Hypertriglyceridemia-Induced Acute Pancreatitis.

评分系统预测高甘油三酯血症诱导的急性胰腺炎严重程度和预后的比较。

  • 影响因子:2.46
  • DOI:10.1007/s10620-019-05827-9
  • 作者列表:"Li M","Xing XK","Lu ZH","Guo F","Su W","Lin YJ","Wang DH
  • 发表时间:2020-04-01
Abstract

BACKGROUND:In China, hyperlipidemia is the second major reason of acute pancreatitis. AIMS:Comparison of Scoring Systems in identification patients at risk for severe acute pancreatitis (SAP), pancreatic necrosis (PNec), and infected pancreatic necrosis (IPN) early in the course of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). METHODS:Predictive accuracy of scoring systems was measured by the area under the receiver operating characteristic curve (AUC) in a retrospective study. Pairwise AUC comparisons were performed to calculate the difference between scoring systems. RESULTS:A total of 238 patients diagnosed with HTG-AP were included. Sixty patients (25.2%) were classified as SAP. Twenty-nine patients (12.2%) had evidence of PNec. Nine patients (3.8%) were diagnosed with IPN. One patient (0.4%) died during hospitalization. In predicting SAP in HTG-AP, the AUCs of APACHE-II, SOFA, SIRS, Ranson's, BISAP, and MMS were 0.77, 0.83, 0.73, 0.88, 0.83, and 0.85, respectively; in predicting PNec, were 0.75, 0.77, 0.75, 0.86, 0.80, and 0.75, respectively; and in predicting IPN, were 0.92, 0.86, 0.76, 0.85, 0.84, and 0.87, respectively. Pairwise AUC comparisons revealed that Ranson's, MMS, BISAP, and SOFA had higher accuracy than SIRS, Ranson's and MMS had higher accuracy than APACHE-II in predicting SAP; Ranson's had the same accuracy with BISAP, but higher than other four criteria in predicting PNec; APACHE-II had higher accuracy than SIRS in predicting IPN. CONCLUSIONS:APACHE-II had high performance in predicting IPN, and all other score systems had medium performance in predicting SAP, PNec, and IPN in HTG-AP. Each score has its merit and weakness; BISAP may be the best criterion in predicting severity and prognosis of HTG-AP.

摘要

背景: 在我国,高脂血症是急性胰腺炎的第二大病因。 目的: 比较评分系统在高甘油三酯血症诱导的急性胰腺炎 (HTG AP) 病程早期识别重症急性胰腺炎 (SAP) 、胰腺坏死 (PNec) 和感染性胰腺坏死 (IPN) 风险的患者。 方法: 在一项回顾性研究中,通过受试者工作特征曲线下面积 (AUC) 测量评分系统的预测准确性。进行成对的AUC比较以计算评分系统之间的差异。 结果: 共纳入238例诊断为HTG-AP的患者。60例患者 (25.2%) 被分类为SAP。29例患者 (12.2%) 有PNec的证据。9例 (3.8%) 患者被诊断为IPN。1例患者 (0.4%) 在住院期间死亡。在预测HTG-AP中的SAP时,APACHE-II、SOFA、SIRS、Ranson's、BISAP和MMS的auc分别为0.77、0.83、0.73、0.88、0.83和0.85; 在预测PNec时,分别为0.75、0.77、0.75、0.86、0.80和0.75,分别为;在预测IPN方面,分别为0.92、0.86、0.76、0.85、0.84和0.87。成对的AUC比较显示,Ranson's,MMS,BISAP和SOFA在预测SAP方面的准确性高于SIRS,Ranson's和MMS在预测SAP方面的准确性高于APACHE-II; Ranson's与BISAP具有相同的准确性,但在预测PNec方面高于其他四个标准; APACHE-II在预测IPN方面比SIRS具有更高的准确性。 结论: APACHE-II在预测IPN方面具有较高的性能,并且所有其他评分系统在预测HTG-AP中的SAP、PNec和IPN方面具有中等性能。每个评分都有其优点和缺点; BISAP可能是预测HTG-AP严重程度和预后的最佳标准。

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影响因子:0.50
发表时间:2020-02-01
DOI:10.1080/00015458.2018.1538283
作者列表:["Aksel B","Güven HE"]

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影响因子:1.74
发表时间:2020-01-01
DOI:10.1016/j.jfma.2019.01.015
作者列表:["Yang SH","Guo JC","Hsu C","Kuo SH","Tien YW","Cheng AL","Yeh KH"]

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胰腺疾病方向

胰腺疾病是发生在胰腺的病理过程,包括胰腺先天性疾病、胰腺损伤性疾病、胰腺炎症性疾病、胰腺囊性病变和胰腺分泌性肿瘤等。

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