Evaluating The Prognosis And Severity Of Severe Acute Pancreatitis By APACHE-Ⅱ Score Associated With CT Classification

Background and ObjectiveSevere acute pancreatitis(SAP) is characterized by serious illness: with pancreatic necrosis and single or multiple organ failure. Recently,with the transparent investigation of SAP and the development of means to diagnosis and treatment in clinical,the prognosis of SAP has improved.But the fatality rate of SAP is still 20%-30%high.To find a better way to judge the prognosis and quantify the severity of the disease wil be very helpful to guide the clinical treament of SAP and reduce mortality.In this research,we retrospectively study 307 histories of SAP patients,using acute physiology and chronic health evaluation (Acute Physiology,Age,and Chronic Health EvaluationⅡ,APACHE-Ⅱ) associated with Balthazar CT scoring system to assess the prognosis and severity of patients with Severe acute pancreatitis(SAP) and find a more reasonable Scoring system.MethodsA total of 307 patients with SAP are enrolled in this study,We study the age,sex,etiology,treatment,APACHE-Ⅱscore of admission within 48h and Balthazar CT score of admission within 72 hours,local complications,systemic complications.resultsThe three groups of CT classification has no significantly difference in gender,age,complications,etiology and complications(P＞0.05).The three groups has a significantly difference in the possibility of surgery, systemic complications and the mortality rate(P＜0.05).associating APACHE-Ⅱscore with Balthazar CT scoring system to assess SAP is significantly better than using APACHE-Ⅱand Balthazar CT score alone. The AUC of associated assessment were 0.923,0.660,0.581,0.718, respectively in predicting the cause of death,possibility of surgery and the incidence of complications.The APACHE-Ⅱscore is better than combined assessment in sensitivity and specificity,But it can not predict the incidence of local complications.The AUC of Balthazar CT score is 0.641 in the incidence of complications,but it can not accurately predict systemic complications and mortality rate of SAP.Conclusion1.APACHE-Ⅱscore can accurately predict the death and systemic complications in severe acute pancreatitis,but can not predict local complications of SAP,and can not predict possibility of surgery accurately.Balthazar CT score can accurately predict the local complications and possibility of surgery in severe acute pancreatitis,but can not accurately predict systemic complications and mortality rate of SAP.2.APACHE-Ⅱscore associated with CT grading score is significantly better than APACHE-Ⅱscore and Balthazar CT score in predicting the death of severe acute pancreatitis,possibility of surgery, systemic and local complications.