The Research Of Mortality Rate Of Sepsis In Emergency Department On Prognosis Of Patients With Acute Pancreatitis Value

Objective:To study the relationship between MEDS score,APACHE score,LAC,PCT and CRP levels and the severity of pancreatitis,and to predict the prognosis of patients with acute pancreatitis.Methods:200 cases of patients with acute pancreatitis from January 2014 to June 2016 in our hospital were retrospectively analyzed,according to the latest standard Atlanta in 2012,acute pancreatitis patients were divided into mild pancreatitis and severe acute pancreatitis and severe acute pancreatitis in 3 groups,the relationship between MEDS score,APACHE?score,lactic acid level,procalcitonin,C-reactive protein and severity of acute pancreatitis were analyzed and evaluated.According to the risk stratification of MEDS,the patients were divided into 3 groups: high,middle and low,the number of survival and death of each group were counted,and the scores of APACHE,LAC,PCT and CRP were analyzed.The selected cases were divided into death group and survival group,the two groups of MEDS score,APACHE score,LAC,PCT and CRP levels were analyzed,then Analysed its relevance and drew the ROC curve.Results:The MEDS score,APACHE score and serum LAC,PCT and CRP levels of three groups were compared under the Atlanta standard,the results showed that the difference of the above indexes between the three groups was significant(P<0.01).Compared with the index of MEDS risk stratification,MEDS>12,8<MEDS<12,MEDS<8 three groups of patients survived the number of cases,the number of cases of death,APACHE score,LAC and CRP the difference was statistically significant(P<0.01).The statistical analysis of the PCT values of the three groups showed no significant difference(P>0.05).With the correlation between APACHE score and MEDS score,the correlation coefficient(r=0.553,P<0.01);LAC level associated with MEDS score,the correlation coefficient(r=0.430,P<0.01);the PCT level and MEDS score had little correlation,correlation coefficient(r=0.120,P>0.05);CRP level associated with MEDS score,the correlation coefficient(r=0.256,P<0.01).The area under the ROC curve of the MEDS score was 0.9609,indicating that the accuracy of the results was high.When the MEDS score was 11.5,the sensitivity and specificity of death in patients with acute pancreatitis were the best,the sensitivity was 53.7% and specificity was 95.8%.The area under the ROC curve of APACHE score was 0.7124,which indicated that the results had good accuracy.When the APACHE score was 8.5,the sensitivity and specificity of death in patients with acute pancreatitis were best,the sensitivity was 72.3% and specificity was 77.6%.The area under the ROC curve of LAC value was 0.7840,which indicated that the prognosis was high.When the LAC value was 2.75mmol/L,the sensitivity and specificity of death in patients with acute pancreatitis were best.The sensitivity was 62.7% and the specificity was about 71.9%.The area under the ROC curve of the PCT value was 0.6605,which showed that the accuracy of the results was low.When the PCT value was 2.77ng/m L,the sensitivity and specificity of death in critically ill patients were the best,with a sensitivity of 45.9% and a specificity of 69.7%.The area under the ROC curve of CRP value was 0.7826,which showed that the accuracy of the results was better.When the CRP value was in 38.5mg/L,the sensitivity and specificity of the death of the critically ill patients were the highest,the sensitivity was 53.6% and the specificity was about 81.7%.Conclusion:The APACHE score,LAC level and CRP level in patients with acute pancreatitis were correlated with MEDS score.The MEDS score in acute pancreatitis was the highest value,followed by LAC and CRP value in the condition of value evaluation,followed by the APACHE score,the assessment of the severity of acute pancreatitis had high value.The value of PCT was the lowest value in predicting the mortality of patients with adverse events,and the value of evaluation was not high.