Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomo...Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.展开更多
以中国气象局逐小时地面降水数据集为参考基准,采用8种统计评价指标综合评估对比了美国NASA研发的全球降水计划(GPM)多卫星降水联合反演IMERG(Integrated Multi-satellitE Retrievals for GPM)卫星降水产品的三个不同版本的Final数据,...以中国气象局逐小时地面降水数据集为参考基准,采用8种统计评价指标综合评估对比了美国NASA研发的全球降水计划(GPM)多卫星降水联合反演IMERG(Integrated Multi-satellitE Retrievals for GPM)卫星降水产品的三个不同版本的Final数据,分析了三套卫星降水在中国大陆地区多时空尺度下的反演精度,探讨了IMERG最新版本V5数据的改进情况及反演中仍然存在的问题.结果表明:IMERG数据能够准确地捕捉到中国大陆地区的降水区域特征,但是在中国西北部地面站点稀疏地区误差较大,精度较低,难以精确估测该地区的实际降水值.最新版本V5数据精度整体上优于先前的V3和V4数据,V5与地面观测数据的相关系数为0.75,均方根误差为7.03 mm/d,较V3、V4有明显提高,改善了V3、V4在中国西北部出现的降水低估问题;但是V5在冬季表现较差且没有解决前期版本存在的高估问题,整体上相对实际降水仍处于高估状态;同时V5在对高雨强事件的捕捉监测能力方面还存在一定的不足,因此建议在强降雨事件监测中需谨慎使用卫星降水IMERG数据集.目前V5系统中的校正算法还存在部分缺陷:为消除全球降水系统性低估问题,目前的校正算法整体性抬升了卫星降水值,从而导致卫星降水反演在中国地区高雨强事件下出现高误报以及高估问题,进而影响到IMERG数据回推以及后续再生数据的精度.展开更多
文摘Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.
