A Single-center Study On The Correlation Between Five Scoring Systems And The Severity Of Acute Pancreatitis Under The New Classification

Objective:Compare the correlation between Balthazar computed tomography severity index,modified Balthazar computed tomography seve rity index,extrapancreatic inflammation on computed tomography,bedsid e index for severity in acute pancreatitis,Japanese acute pancreatitis seve rity score,and the severity of acute pancreatitis under 2012 Atlanta acute pancreatitis classification.Methods:We retrospectively analyzed the clini cal and CT data of 116 patients with acute pancreatitis in Affiliated Hos pital of Southwest Medical University from January 2001 to May 2016,a nd analyzed the value of the area under the ROC curve of the five scor es to predict the severity of acute pancreatitis;At last,build the Fisher di scriminant equation.Results:There were 61 cases(52.6%)of males and55 cases(47.4%)of female,84 cases(72%)in the non-elderly group an d 32 cases(28%)in the elderly group,64 cases of mild AP(55.2%)、42 cases of moderate severe AP(36.2%)and 10 cases of severe AP(8.6%),4 cases died(3.4%);The scores of CTSI,MCTSI,EPIC,BISAP a nd JSS in MAP patients were(2.53±0.93),(2.76±0.71),(2.08±0.74),(1.06±0.59),(1.20±0.67),the scores in MSAP patients were(5.17±1.15),(5.83± 0.94),(3.52±1.09),(2.20±0.74)and(3.19±1.04),The scores in SAP patients were(5.50±1.99),(7.00±2.11),(5.90±1.45),(3.25±1.06),(5.50±1.43),five scores were positively correlated,and the dif ferences between each other were statistically significant(all P<0.05).The ROC values of CTSI,MCTSI,EPIC,BISAP,JSS score to predict SAP when MAP combined with MSAP were 0.814,0.815,0.865,0.836,0.849,the differences were statistically significant(P<0.05).Conclusion:(1)E PIC evaluates SAP’s AUC value up to 0.865(95% confidence interval 0.790-0.913),which predicts the highest value of SAP;BISAP and JSS sco re can also precisely predict SAP,diagnostic values were higher than CT SI and MCTSI scores.(2)There were significant differences in the severity of AP predicted by the five scores,and the value evaluation of predict AP was positively correlated,the difference was statistically significant;F isher’s stepwise discriminant analysis established the best diagnostic model of AP,and got three AP diagnostic discriminant functions.(3)SAP death(75.0%)was higher than MSAP death(25.0%),the difference was not st atistically significant,It is suggested that maybe the relationship between organ failure and mortality is high.(4)elderly patients are more susceptible to AP,and necrotizing AP is more common,more distributed in the etio logy of gallstone,the severity more distributed in moderate and severe A P,there were statistically significant differences;elderly patients died in 3 c ases were higher than non elderly patients died in 1 cases,no significant difference,it is suggested that age may be the independent risk factors of AP.(5)Patients with gallstone disease because of necrosis and hyperlipide mia more than the edematous patients because of gallstone and high fat,the difference was statistically significant;there were 4 cases of necrosis type of death more than edema type in 0 cases,the difference was not s tatistically significant,suggesting that necrosis is still an important risk fa ctors of AP.