Yoğun bakıma alınan fliddetli akut pankreatit: SOFA skoru prognozu belirlemede Ranson ve APACHE II Skorundan üstündür
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Şiddetli akut pankreatit genellikle kardiyovaskuler, pulmoner, renal ve septik komplikasyonlar açısından yoğun izlem gerektirir. Prognozu belirlemede birçok skorlama sistemi kullanılır. Bu çalışmanın amacı yoğun bakıma alınan şiddetli akut pankreatit olgularında akut fizyoloji ve kronik sağlık değerlendirme II skoru, ardışık organ yetmezliği değerlendirme ve modifiye Ranson skoru kullanılarak bu skorların mortaliteyi tahmin etmedeki değerini ve mortalite ile ilişkili diğer faktörleri saptamaktır. Gereç ve Yöntem: Şiddetli akut pankreatit nedeniyle yoğun bakıma alınan 43 hasta dosyası retrospektif olarak incelendi. Dört hasta çalışmaya alınmadı. Akut fizyoloji ve kronik sağlık değerlendirme II, ardışık organ yetmezliği değerlendirme ve modifiye Ranson skorları hasta yatışında, ardışık organ yetmezliği değerlendirme skoru yoğun bakım yatışı boyunca her hafta hesaplandı. Bulgular: 39 hasta çalışmaya alındı (%65 erkek, yaş ortalaması: 61 yıl). Yoğun bakım mortalitesi %64, hastane mortalitesi %71 bulundu. Yoğun bakımda yatışı süresince herhangi bir zamanda ardışık organ yetmezliği değerlendirme skoru >11 seyredenlerde mortalite daha yüksekti (sensitivite %80, spesifisite %79, ROC=0,837). Mortaliteyi tahmin etmede kullanılan akut fizyoloji ve kro- nik sağlık değerlendirme II ile istatistiksel olarak anlamlı bir ilişki gösterilemedi. Sonuç: Şiddetli akut pankreatitte prognozunu belirlemede birçok skorlama sistemi kulllanılmaktadır. Bu grup hastalarda ardışık organ yetmezliği değerlendirme skoru yüksek olduğunda yoğun bakım ve hastane mortalitesinde artış olarak sonuçlanır.
Background/aims: Severe acute pancreatitis usually requires intensive management of cardiovascular, pulmonary, renal, and septic complications. Many scoring systems are used in determining the outcomes. The aim of the study was to evaluate the role of three scoring systems, i.e. Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and modified Ranson's criteria, in predicting mortality rate in patients with severe acute pancreatitis as well as other factors influencing morta- lity in patients admitted to intensive care unit. Materials and Methods: Charts of 43 patients hospitalized in intensive care unit with severe acute pancreatitis were screened retrospectively. Four patients were excluded. Acute Physiology and Chronic Health Eva- luation II, Sequential Organ Failure Assessment and modified Ranson's scores were calculated on admission, and Sequential Or- gan Failure Assessment score was recorded on weekly intervals during the intensive care unit stay. Results: Thirty-nine patients were included in the study (65% male, mean age: 61 years). The intensive care unit mortality was 64% and hospital mortality was 71%. Sequential Organ Failure Assessment scores correlated significantly with mortality. All patients with Sequential Organ Fa- ilure Assessment score >=11 at any time during intensive care unit stay had higher mortality (80% sensitivity, 79% specificity, ROC=0,837). Although Acute Physiology and Chronic Health Evaluation II is used to estimate mortality prognosis, we could not find any statistically significant association between Acute Physiology and Chronic Health Evaluation II scores and mortality. Conclusion: Various scoring systems are used to determine the prognosis of severe acute pancreatitis. In this group of patients, hig- her Sequential Organ Failure Assessment scores predict higher intensive care unit/hospital mortality.
Background/aims: Severe acute pancreatitis usually requires intensive management of cardiovascular, pulmonary, renal, and septic complications. Many scoring systems are used in determining the outcomes. The aim of the study was to evaluate the role of three scoring systems, i.e. Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and modified Ranson's criteria, in predicting mortality rate in patients with severe acute pancreatitis as well as other factors influencing morta- lity in patients admitted to intensive care unit. Materials and Methods: Charts of 43 patients hospitalized in intensive care unit with severe acute pancreatitis were screened retrospectively. Four patients were excluded. Acute Physiology and Chronic Health Eva- luation II, Sequential Organ Failure Assessment and modified Ranson's scores were calculated on admission, and Sequential Or- gan Failure Assessment score was recorded on weekly intervals during the intensive care unit stay. Results: Thirty-nine patients were included in the study (65% male, mean age: 61 years). The intensive care unit mortality was 64% and hospital mortality was 71%. Sequential Organ Failure Assessment scores correlated significantly with mortality. All patients with Sequential Organ Fa- ilure Assessment score >=11 at any time during intensive care unit stay had higher mortality (80% sensitivity, 79% specificity, ROC=0,837). Although Acute Physiology and Chronic Health Evaluation II is used to estimate mortality prognosis, we could not find any statistically significant association between Acute Physiology and Chronic Health Evaluation II scores and mortality. Conclusion: Various scoring systems are used to determine the prognosis of severe acute pancreatitis. In this group of patients, hig- her Sequential Organ Failure Assessment scores predict higher intensive care unit/hospital mortality.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Turkish Journal of Gastroenterology
WoS Q Değeri
Scopus Q Değeri
Cilt
24
Sayı
5
