BACKGROUND: It has been suggested that addition of obesity score to the APACHE-Ⅱ system can lead to more accurate prediction of severity of acute pancreatitis. However there is scanty information on the usefulness of...BACKGROUND: It has been suggested that addition of obesity score to the APACHE-Ⅱ system can lead to more accurate prediction of severity of acute pancreatitis. However there is scanty information on the usefulness of the combined APACHE-O scoring system in Asian patients. This study aimed to compare the accuracy of Ranson, APACHE-Ⅱ and APACHE-O systems in assessing severity of acute pancreatitis in a local Chinese population. METHODS: One hundred and one consecutive patients with acute pancreatitis were prospectively studied. Body mass index (BMI) was measured on admission. Ranson score, APACHE-Ⅱ and APACHE-O scores were recorded on admission and at 48 hours. By adopting the cut-off levels and definitions advocated in the Atlanta consensus for severe disease, the diagnostic accuracy of the three scoring systems was compared by the area under the curve (AUC) under the receiver operator characteristic curve. RESULTS: Of the 101 patients, 12 (11.9%) patients suffered from severe pancreatitis. Obesity was uncommon and only two patients (2.0%) had BMI >30. Eighty-two (81.2%) patients were normal weight (BMI≤25) whereas 17 (16.8%) were overweight ( BMI 25-30 ). Overweight or obesity (BMI >25) was not associated with severe pancreatitis (P= 0.40). The AUC for admission scores of Ranson, APACHE-Ⅱ, and APACHE-O systems was 0. 549, 0. 904 and 0. 904, respectively. The AUC for 48-hour scores of Ranson, APACHE-Ⅱ and APACHE-O systems was 0.808, 0.955 and 0.951, respectively. CONCLUSIONS: The APACHE-Ⅱ scoring system is more accurate than the Ranson scoring system of the prediction of severity in acute pancreatitis. Addition of obesity score does not significantly improve the predictive accuracy of the APACHE-Ⅱ system in our local population with a low prevalence of obesity.展开更多
目的:通过利用POSSUM、P-POSSUM和APACHE-Ⅱ评分对我院行手术治疗的肝门部胆管癌病例的术后住院死亡率的预测进行预测,评价各评分的预测能力,为肝门部胆管癌术后死亡风险寻求有效的评估方法。方法:收集了2002年1月～2007年12月期间在东...目的:通过利用POSSUM、P-POSSUM和APACHE-Ⅱ评分对我院行手术治疗的肝门部胆管癌病例的术后住院死亡率的预测进行预测,评价各评分的预测能力,为肝门部胆管癌术后死亡风险寻求有效的评估方法。方法:收集了2002年1月～2007年12月期间在东方肝胆外科医院接受手术治疗的348例肝门部胆管癌的病例资料,统计其手术后的住院死亡率;统计学方法:所有的数据通过SPSS15.0 for windows、Medcalc9.2.10 for windows进行分析处理,计量资料经t检验、计数资料以x2检验和Z检验,P<0.05为有统计学意义;O:E值和ROC曲线用来评价评分方法的判别能力。结果:348例患者的术后有6例发生住院期间死亡,死亡率为1.7%,POSSUM评分预测的住院死亡率为9.3%(33例),两者之间的差异有统计学意义(x2=19.80,df=1,P<0.01);P-POSSUM评分预测的住院死亡率2.8%(10例),两者之间的差异无统计学意义(x2=1.02,df=1,P>0.05);APACHE-Ⅱ评分预测的住院死亡率9.2%(32例),两者之间的差异有统计学意义(x2=18.82,df=1,P<0.01)。POSSUM、P-POSSUM和APACHE-Ⅱ评分对应的ROC曲线下面积分别为0.759、0741和0.608。结论:P-POSSUM评分能很好的预测肝门部胆管癌手术的术后住院死亡率,POSSUM和APACHE-Ⅱ评分不能准确的预测,明显高估了术后死亡风险。展开更多
文摘BACKGROUND: It has been suggested that addition of obesity score to the APACHE-Ⅱ system can lead to more accurate prediction of severity of acute pancreatitis. However there is scanty information on the usefulness of the combined APACHE-O scoring system in Asian patients. This study aimed to compare the accuracy of Ranson, APACHE-Ⅱ and APACHE-O systems in assessing severity of acute pancreatitis in a local Chinese population. METHODS: One hundred and one consecutive patients with acute pancreatitis were prospectively studied. Body mass index (BMI) was measured on admission. Ranson score, APACHE-Ⅱ and APACHE-O scores were recorded on admission and at 48 hours. By adopting the cut-off levels and definitions advocated in the Atlanta consensus for severe disease, the diagnostic accuracy of the three scoring systems was compared by the area under the curve (AUC) under the receiver operator characteristic curve. RESULTS: Of the 101 patients, 12 (11.9%) patients suffered from severe pancreatitis. Obesity was uncommon and only two patients (2.0%) had BMI >30. Eighty-two (81.2%) patients were normal weight (BMI≤25) whereas 17 (16.8%) were overweight ( BMI 25-30 ). Overweight or obesity (BMI >25) was not associated with severe pancreatitis (P= 0.40). The AUC for admission scores of Ranson, APACHE-Ⅱ, and APACHE-O systems was 0. 549, 0. 904 and 0. 904, respectively. The AUC for 48-hour scores of Ranson, APACHE-Ⅱ and APACHE-O systems was 0.808, 0.955 and 0.951, respectively. CONCLUSIONS: The APACHE-Ⅱ scoring system is more accurate than the Ranson scoring system of the prediction of severity in acute pancreatitis. Addition of obesity score does not significantly improve the predictive accuracy of the APACHE-Ⅱ system in our local population with a low prevalence of obesity.
文摘目的:通过利用POSSUM、P-POSSUM和APACHE-Ⅱ评分对我院行手术治疗的肝门部胆管癌病例的术后住院死亡率的预测进行预测,评价各评分的预测能力,为肝门部胆管癌术后死亡风险寻求有效的评估方法。方法:收集了2002年1月～2007年12月期间在东方肝胆外科医院接受手术治疗的348例肝门部胆管癌的病例资料,统计其手术后的住院死亡率;统计学方法:所有的数据通过SPSS15.0 for windows、Medcalc9.2.10 for windows进行分析处理,计量资料经t检验、计数资料以x2检验和Z检验,P<0.05为有统计学意义;O:E值和ROC曲线用来评价评分方法的判别能力。结果:348例患者的术后有6例发生住院期间死亡,死亡率为1.7%,POSSUM评分预测的住院死亡率为9.3%(33例),两者之间的差异有统计学意义(x2=19.80,df=1,P<0.01);P-POSSUM评分预测的住院死亡率2.8%(10例),两者之间的差异无统计学意义(x2=1.02,df=1,P>0.05);APACHE-Ⅱ评分预测的住院死亡率9.2%(32例),两者之间的差异有统计学意义(x2=18.82,df=1,P<0.01)。POSSUM、P-POSSUM和APACHE-Ⅱ评分对应的ROC曲线下面积分别为0.759、0741和0.608。结论:P-POSSUM评分能很好的预测肝门部胆管癌手术的术后住院死亡率,POSSUM和APACHE-Ⅱ评分不能准确的预测,明显高估了术后死亡风险。
