Selen ACEHAN, Salim SATAR, Müge GÜLEN, Başak TOPTAŞ FIRAT, Deniz Aka SATAR, Adnan TAŞ

65 yaş üstü hastalarda puanlama sistemlerinin şiddetli akut pankreatiti ve mortaliteyi erken öngörme açısından değerlendirilmesi

Amaç: Bu çalışmanın amacı, acil serviste akut pankreatit tanısı alan 65 yaş üstü hastalarda hastalık şiddeti skorlarının erken dönemde Şiddetli Akut Pankreatit (SAP) gelişimini ve mortaliteyi öngörme gücünü araştırmayı amaçladık. Gereç ve Yöntem: Acil servise başvuru sırasında Yatak Başı Akut Pankreatit Şiddet İndeksi (BISAP) skoruna ek olarak RANSON (ilk başvuru) ve Bilgisayarlı Tomografi Şiddet İndeksi (CTSI) hesaplandı. Bulgular: Çalışmaya yüz altmış hasta (%46,9'u 80 yaş üstü) dahil edildi. 80 yaş üstü hastalarda istatistiksel olarak daha yüksek hastanede yatış süresi, yoğun bakımda kalış süresi, SAP ve daha yüksek mortalite gözlemledik. ROC eğrisini incelediğimizde, BISAP puanının AUC değerlerinin hem SAP hem de mortalite tahmininde en yüksek olduğunu belirledik (AUC: 0.911, %95 CI 0.861-0.962; AUC: 0.918, %95 CI 0.864- 0.9722, sırasıyla). İkili lojistik analiz, BİSAP puan değerindeki her birim artış için SAP için 4,7 kat artan risk ve 12,3 kat artan ölüm oranı gösterdi. Sonuç: BISAP, 65 yaş üstü akut pankreatitli hastalarda acil servise başvuruda SAP ve mortalite tahmini için iyi bir öngörücü olabilir.

Evaluation of scoring systems in terms of early prediction of severe acute pancreatitis and mortality in patients over 65 years of age.

Purpose: The aim of this study is to investigate the power of disease severity scores to predict the development of Severe Acute Pancreatitis (SAP) and mortality in the early period over 65 years old diagnosed with acute pancreatitis in the emergency department. Materials and Methods: We calculated RANSON (on admission) and Computed Tomography Severity Index (CTSI) in addition to Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission to the emergency department. Results: One hundred and sixty patients (46.9% over 80 years of age) were included in the study. We observed statistically higher length of hospitalization, longer duration of stay in the intensive care unit, SAP and higher mortality in patients over 80 years of age. When we examined the ROC curve, we determined that the AUC values of the BISAP score were highest in both SAP and mortality estimation (AUC: 0.911, 95% CI 0.861-0.962; AUC: 0.918, 95% CI 0.864-0.9722, respectively). Binary logistic analysis indicated a 4.7-fold increased risk for SAP and a 12.3-fold increased mortality for each unit increase in BISAP score value. Conclusion: BISAP may be a good predictor for SAP and mortality estimation on admission to the emergency department in patients over 65 years of age with acute pancreatitis.

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