如何在紧急情况下对急性胰腺炎进行评分:针对ED-SAS的五个系统

IF 1 4区 医学 Q3 EMERGENCY MEDICINE Signa Vitae Pub Date : 2021-08-31 DOI:10.22514/sv.2021.147
M. Erdogan, Nihat Müjdat Hökenek
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引用次数: 4

摘要

评估一种名为“急诊科SpO2(外周毛细血管血氧饱和度)、年龄和SIRS(全身炎症反应综合征)”(ED-SAS)的新量表的有效性,该量表可用于预测急诊科患者出现急性胰腺炎后24小时内的预后。本研究项目为单中心回顾性队列研究。患者的急性生理学和慢性健康评估II(APACHE II)、SIRS、急性胰腺炎床旁严重程度指数(BISAP)、ED-SAS、改良格拉斯哥量表和Ranson标准评分使用从医院自动化系统中筛选的表现数据进行评估。然后,使用接收操作曲线(ROC)对这些评估系统的效率进行比较。用Kolmogorov-Smirnov检验检验数据与正态分布的一致性。ROC分析用于确定计算死亡率时评分系统的截止值。DeLong等人开发的方法用于比较评分系统的ROC曲线。该研究共有235名患者完成,其中91名(38.7%)为男性,144名(61.3%)为女性,平均年龄为63.1±17.7岁。在ED-SAS评估工具预测死亡率的ROC分析中,发现曲线下面积(AUC)值为0.85(95%置信区间:0.79–0.89),Youden指数为0.62,p值为0.001。ED-SAS的死亡率预测与Ranson和SIRS评分系统相比有显著差异(分别为P=0.001和P=0.03)。然而,ED-SAS评分与改良的Glasgow和APACHE II评分的比较没有发现统计学上的显著差异(分别为P=0.12和P=0.54)。结论是,在95%置信区间下,基带ED-SAS评分在AUC方面提供了同样显著的结果(P=0.05)。统计分析显示,与幸存者相比,死者的APACHE II、SIRS、BISAP、改良格拉斯哥和ED-SAS评分显著更高(P<0.05),一种方便有效的评估系统,可用于在紧急情况下预测急性胰腺炎的死亡率。
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How to score acute pancreatitis in the emergency setting: five systems against ED-SAS
To assess the effectiveness of a new scale known as “Emergency department SpO2 (peripheral capillary oxygen saturation), age, and SIRS (Systemic inflammatory response syndrome)” (ED-SAS) that can be used to predict prognosis within 24 hours following presentation compatible with acute pancreatitis in patients admitted to the emergency department. This research project was conducted as a single-center, retrospective, cohort study. The Acute Physiology and Chronic Health Evaluation II (APACHE II), SIRS, Bedside Index for Severity in Acute Pancreatitis (BISAP), ED-SAS, modified Glasgow Scale and Ranson criteria scoring of the patients were evaluated using their presentation data screened from the hospital automation system. Then, the efficiencies of these evaluation systems were compared using the receiving operating curve (ROC). The conformity of the data to the normal distribution was checked with the Kolmogorov-Smirnov test. The ROC analyses were employed to identify the cut-off values of the scoring systems in calculating death rates. The method developed by DeLong et al. was used to compare the ROC curves of the scoring systems. The study has been completed with 235 patients, 91 (38.7%) male and 144 (61.3%) female, with a mean age of 63.1 ± 17.7 years. In the ROC analysis of the ED-SAS evaluation tool to predict death rates, the area under the curve (AUC) value was found to be 0.85 (95% confidence interval: 0.79–0.89), and the Youden index was 0.62, with a p value of 0.001. Mortality prediction with ED-SAS significantly differed compared to the Ranson and SIRS scoring systems (P = 0.001 and P = 0.03, respectively). However, no statistically significant difference was found in the comparison of the ED-SAS score with the modified Glasgow and APACHE II scores (P = 0.12 and P = 0.54, respectively). It was concluded that the Baseband ED-SAS scores provided equally significant results in terms of AUC at the 95% confidence interval (P = 0.05). Statistical analyses revealed that the APACHE II, SIRS, BISAP, modified Glasgow and ED-SAS scores were found to be significantly higher among the dead in comparison to the survivors (P < 0.05). ED-SAS constitutes a simple, fast, expedient and effective evaluation system that can be utilized to predict mortality in acute pancreatitis in the emergency setting.
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来源期刊
Signa Vitae
Signa Vitae 医学-急救医学
CiteScore
1.30
自引率
9.10%
发文量
0
审稿时长
3 months
期刊介绍: Signa Vitae is a completely open-access,peer-reviewed journal dedicate to deliver the leading edge research in anaesthesia, intensive care and emergency medicine to publics. The journal’s intention is to be practice-oriented, so we focus on the clinical practice and fundamental understanding of adult, pediatric and neonatal intensive care, as well as anesthesia and emergency medicine. Although Signa Vitae is primarily a clinical journal, we welcome submissions of basic science papers if the authors can demonstrate their clinical relevance. The Signa Vitae journal encourages scientists and academicians all around the world to share their original writings in the form of original research, review, mini-review, systematic review, short communication, case report, letter to the editor, commentary, rapid report, news and views, as well as meeting report. Full texts of all published articles, can be downloaded for free from our web site.
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