Sequential organ failure assessment score is superior to other prognostic indices in acute pancreatitis

作     者：Thomas Zheng Jie Teng Jun Kiat Thaddaeus Tan Samantha Baey Sivaraj K Gunasekaran Sameer P Junnarkar Jee Keem Low Cheong Wei Terence Huey Vishal G Shelat 

作者机构：Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Undergraduate MedicineLee Kong Chian School of MedicineSingapore 308232Singapore Department of General SurgerySingapore General HospitalSingapore 169608Singapore Undergraduate MedicineYong Loo Lin School of MedicineSingapore 119077Singapore 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2021年第10卷第6期

页      面：355-368页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Pancreatitis Severity scoring Intensive care unit Mortality Sequential Organ Failure Assessment score Ranson’s score 

摘      要：BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially *** prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict *** To evaluate these indices utility in predicting severity,intensive care unit(ICU)admission,and *** A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was *** demographic,clinical profile,and patient outcomes were *** was defined as per the revised Atlanta *** for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic *** with10%missing data was imputed via mean *** patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical *** The mean age was 58.7±17.5 years,with 58.7%***(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to ***’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy i