Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis - Evaluation of a new scoring system
Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis - Evaluation of a new scoring system
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DOI：
10.1097/mpa.0b013e31802d4136
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发表时间：
2007-03-01
期刊：
影响因子：
2.9
通讯作者：
Colardyn, Francis A.
中科院分区：
文献类型：
--
作者：
De Waele, Jan J.;Delrue, Louke;Colardyn, Francis A.
目的：介绍了一种新的评分系统的基础上的迹象，全身炎症的计算机断层扫描（CT）[胰腺外炎症CT（EPIC）评分]和评估这个分数作为一个早期预后too]方法：40例急性胰腺炎患者接受腹部CT后24小时内入院被纳入本研究。计算所有患者的Balthazar评分、CT严重程度指数和EPIC评分（基于是否存在胸腔积液、腹水和腹膜后积液）。终点为重症急性胰腺炎（局部并发症或器官衰竭超过48小时）和住院死亡率。通过计算受试者工作特征曲线（ROC）和ROC曲线下面积来评估该评分。结果：患者平均年龄为50（+/- 17.7）岁，兰森评分为3.3。14例（35%）患者出现严重疾病;住院死亡率为15%（6/40）。平均EPIC评分为3.6（+/- 2.0）。预测严重疾病和死亡率的ROC曲线下面积分别为0.91（95%置信区间，0.83-0.99）和0.85（95%置信区间，0.71-0.99）。EPIC评分≥ 4分预测重症胰腺炎的敏感性为100%，特异性为70.8%。EPIC评分上级Balthazar评分和CT严重程度指数预测outcome.Conclusions：在急性胰腺炎患者中，胰腺外炎症评估腹部CT扫描和量化的EPIC评分可以准确估计疾病的严重程度和死亡率在24小时内入院。
Objective: To introduce a new scoring system based on signs of systemic inflammation on computed tomography (CT) [ExtraPancreatic Inflammation on CT (EPIC) score] and evaluate this score as an early prognostic too].Methods: Forty patients with acute pancreatitis who received an abdominal CT within 24 It after admission were included in the study. The Balthazar score, the CT Severity Index, and the EPIC score (based on the presence of pleural effusion, ascites, and retroperitoneal fluid collections) were calculated for all patients. The end points were the occurrence of severe acute pancreatitis (local complication or presence of organ failure for more than 48 h) and in hospital mortality. This score was evaluated by calculating receiver operator characteristic (ROC) curves and the area under the ROC curve.Results: Mean age of the patients was 50 (+/- 17.7) years, and Ranson score was 3.3. Fourteen (35%) patients developed severe disease; in hospital mortality was 15% (6/40). The mean EPIC score was 3.6 (+/- 2.0). The area under the ROC curve for predicting severe disease and mortality was 0.91 (95% confidence interval, 0.83-0.99) and 0.85 (95% confidence interval, 0.71-0.99), respectively. An EPIC score of 4 or more had a 100% sensitivity and 70.8% specificity for predicting severe pancreatitis. The EPIC score was superior to the Balthazar score and CT Severity Index to predict outcome.Conclusions: In patients with acute pancreatitis, extrapancreatic inflammation assessed by abdominal CT scan and quantified with the EPIC score allows accurate estimation of disease severity and mortality within 24 h of admission.