The Value Of The Quick Sequential Organ Failure Assessment Score In The Evaluation Of Prognosis Of Acute Pancreatitis

Objective:To compare the scores of qSOFA and BISAP and RANSON scores,and to evaluate the prognostic value of each scoring system in predicting the prognosis of patients with acute pancreatitis.Methods:the clinical data of patients with acute pancreatitis diagnosed at the First Affiliated Hospital of Wannan Medical College from January 2017 to December 2018were followed up.The clinical and imaging data and laboratory data of the patients were recorded,including respiratory frequency,CO₂ pressure,blood pressure,Glasgow score,LDH,AST,BUN,body temperature,pulse,WBC count,naive neutrophils count,pleural effusion or not,Complete the RANSON score within 48 hours,Application of BISAP score in 24 h,The qSOFA score was completed within 2 minutes of admission;all the statistical data were analyzed by SPSS22.0 and MedCalc software packages and ROC curve was used to evaluate BISAP.The accuracy of qSOFA in the diagnosis of acute pancreatitis was evaluated.Regression analysis was used to assess the relationship between the related indexes and the clinical prognosis,and to evaluate the prognosis of the three grades by the ROC curve.Results:among the 201 cases,there were 114 male cases and 87 female cases,male:female is114:87;the age distribution was 12-92 years old,the average age was 55 years,the median was 53,the<18 age was 4,the 18⁶0 year old was 110,and the>60 was 87.There were 151 cases of rural patients,158 patients received the general ward,43patients admitted to the intensive medicine department（included EICU,ICU）,the average time of treatment was 17 days.After 12 months follow-up,140 cases were cured,15 cases died,5 cases had complications,all the complications were diagnosed by imaging,2 cases had complications.2 patients had complications.Pancreatic pseudocysts were not treated by self absorption after 8 weeks.1 cases of peripancreatic abscess were treated with surgical treatment and 2 patients were converted to chronic pancreatitis.The area of BISAP,RANSON,and qSOFA scores for the prediction of ICU was 0.892（0.845--0.940）,0.901（0.852--0.950）,0.909（0.860--0.957）);the area under the ROC curve of the predictionvalue of BISAP,RANSON and qSOFA for prognosis was0.917（0.863--0.971）,0.961（0.930--0.991）,0.848（0.736--0.960）.Conclusion:1.As a scoring system for predicting the admission of AP patients to ICU,qSOFA score has good sensitivity and insufficient specificity.2.As a prognostic scoring system for AP patients,qSOFA score is less valuable than BISAP and RANSON score.