The Study Of The Methods In Early Evaluation Of The Severity Of Acute Pancreatitis

Objective: Acute pancreatitis(AP) is one of most common diseases in our country. Now it has became the main problem which is harmful to our people's health. Early evaluation of the severity of acute pancreatitis is very important and regarded as a precondition for successful treatment.. It has important implication for management of the disease, judgement of prognosis, and medical resource utilization. The goal of this study was to analyze 10 variables of patients with AP in order to look for a simplified scoring system for early evaluation of acute pancreatitis.Methods: A total of 102 patients with acute pancreatitis were analyzed retrospectively in this study to evaluated the values of 10 variables in early prediction of the severity of acute pancreatitis. These 10 clinical and biochemical factors were presented within 24h after admission included : age =2= 60years old, pulse > 100/min, body temperature> 3 8C, systolic pressure <90mmHg, positive of peritoneal irritation sign, bowel sounds vanish, blood sugar> 11.1 mmol/L, white blood cell count>20.0 X 109 / L, serum calcium<1.87mmol/L, partial pressure of oxygen in arterial blood < 60mmHg. We used CTSI(CT severity index ) as gold standard to divided 102 patients into two groups, the mild group and the sever group, we compared these 10 variables between these two groups and choosed the valuable variables to develop a new scoring system to evaluate these patients with AP .Then wecompared it with APACHE II scoring system.Results: Among 102 patients, 80 patients developed a mild acute pancreatitis as a mild group and 22 patients developed a severe acute pancreatitis as a sever group. Among these 10 variables ,9 variables were significantly higher in the severe group (p<0.05).these 9 variables included: age>60years old, body temperature >3 8C, systolic pressure< 90mmHg, positive of peritoneal irritation sign, bowel sounds vanish, blood sugar> 1 l.lmmol/L, white blood cell count>20.0 X 109 / L, serum calcium< 1.87mmol/L, partial pressure of oxygen in arterial blood< 60mmHg. We used these 9 variables to develop a new multifactorial scoring system to evaluate these 102 patients with AP . The sensitivity ,specificity, positive and negative predictive ,accuracy of this scoring system are 77.3%, 72.5%, 43.6%, 92.1%, 71.5%,. It was compared with APACHE II scoring system ,their predictive value are resemble .Conclusion: 10 variables were used to evaluate the severity of acute pancreatitis in this study ,among them ,9 variables were valuable. Using them ,we developed a new scoring system and cmopared it with APACHE II scoring system, their predictive value are resemble. Our system is easy to use, so it was better than APACHE II in clinical practical application .