The Function Of Sequential Organ Failure Assessment Score Combined With C-reactive Protein In The Study Of The Severity And Prognosis Of Acute Pancreatitis

【Objective and Method】Objective:To explore the value of Sequential organ failure assessment(SOFA)score combined with C-reactive protein(CRP)concentration in predicting the severity and prognosis of moderately severe acute pancreatitis(MSAP)and severe acute pancreatitis(SAP)。Method:A total of 116 cases of patients who were diagnosed as “MSAP” or “SAP” when they were discharged at Shanghai Changhai hospital from 2016-1 to 2017-1 were retrospectively analyzed。The levels of amylase、lipase、procalcitonin、serum glucose、serum calcium、CRP concentration 、 D-dimer and the imaging information were measured。CRP was measured in 48 hours since the symptom appeared.According to the each score evaluation standard,the BISAP score、APACHE II score、Ranson score、CTSI score、SOFA score were obtained。We compared the predictive value in the severity and prognosis of CRP 、SOFA score and other scoring systems in MSAP and SAP。We also compared the the authenticity and accuracy between SOFA score、CRP concentration and the combined index in predicting the severity and prognosis of MSAP and SAP。【Result】The highest SOFA score、initial SOFA score、APACHE II score、BISAP score、Ranson score、CTSI score、CRP concentration in predicting the severity of moderately and severe acute pancreatitis,YI is 0.761、0.721、0.747、0.501、0.465、0.428、0.335 respectively,AUC is 0.938、0.899、0.916、0.815、0.820、0.735、0.685 respectively,P<0.05;in predicting mortality:YI is 0.753、0.730、0.745、0.373、0.518、0.493、0.449 respectively,AUC is 0.908、0.930、0.885、0.734、0.816、0.779、0.707 respectively,P<0.05;in predicting organ failure,YI is 0.582、0.631、0.488、0.396、0.468、0.324、0.517 respectively,AUC is 0.860、0.860、0.804、0.745、0.793、0.676、0.800 respectively,P<0.05;in predicting pancreatic necrosis,YI is 0.396、0.377、0.417、0.305、0.316、0.656、0.449 respectively,AUC is 0.704、0.685、0.689、0.669、0.709、0.829、0.727 respectively,P<0.05;in predicting the needs to stay in ICU,YI is 0.429、0.412、0.492、0.276、0.331、0.285、0.371 respectively,AUC is 0.704、0.709、0.773、0.653、0.683、0.845、0.681 respectively,P<0.05。The highest SOFA score combined with CRP concentration、initial SOFA score combined with CRP concentration、highest SOFA score、initial SOFA score、CRP concentration in predicting the severity of moderately and severe acute pancreatitis YI is 0.757、0.743、0.593、0.650、0.517 respectively,AUC is 0.926、0.930、0.862、0.866、0.800 respectively,P<0.05;in predicting organ failure,YI is 0.757、0.743、0.593、0.650、0.517 respectively,AUC is 0.926、0.930、0.862、0.866、0.800,P<0.05;in predicting pancreatitc necrosis,YI is 0.513、0.480、0.410、0.390、0.423 respectively,AUC is 0.780、0.776、0.722、0.695、0.727 respectively,AUC is 0.780、0.776、0.722、0.695、0.727 respectively,P<0.05;in predicting mortality,YI is 0.743、0.708、0.729、0.722、0.420 respectively,AUC is 0.906、0.935、0.906、0.927、0.707 respectively,P<0.05;in predicting the needs to stay in ICU,YI is 0.432、0.409、0.432、0.402、0.371 respectively,AUC is 0.732、0.736、0.707、0.706、0.681 respectively,P<0.05。【Conclusion】Both the highest SOFA score、initial SOFA score、APACHE II score、BISAP score、Ranson score、CTSI score、CRP concentration can predict the severity and prognosis which include mortality、organ failure、pancreatic necrosis、needs to stay in the ICU of moderately and severe acute pancreatitis。The highest SOFA score、initial SOFA score have a great authenticity and accuracy in predicting the severity of moderately and severe acute pancreatitis and their mortality、organ failure。Although in predicting pancreatic necrosis,CTSI score has the best authenticity and accuracy,the highest SOFA score、initial SOFA score have the similar ability compared with APACHE II score。The highest SOFA score、initial SOFA score can predict the needs to stay in the ICU to some extend。Both the highest SOFA score combined with CRP concentration、initial SOFA score combined with CRP concentration、 highest SOFA score、initial SOFA score、CRP concentration can predict the severity and prognosis which include mortality、organ failure、pancreatic necrosis、needs to stay in the ICU of moderately and severe acute pancreatitis。SOFA score combined with CRP concentration has a great value in predicting the severity of moderately and severe acute pancreatitis and prognosis including mortality、organ failure and can partly predict pancreatic necrosis;In predicting mortality and the needs to stay in ICU,although the authenticity of initial SOFA score combined with CRP concentration has declined,the difference is little compared with the single initial SOFA score,both the combined index and SOFA score alone can have a great value in predicting the mortality,and the combined index has the highest accuracy in predicting the needs to stay in ICU.