Abidin TÜZÜN, Erkan DALBAŞI, Mesut GÜL

Akut Biliyer Pankreatit’li Hastalarda Apache II, Ranson ve Balthazar Skorlama Sistemlerinin Morbidite Tahminindeki Rolü

GİRİŞ ve AMAÇ: Akut pankreatit tanısı alan hastaların tedavisinin planlanması hastalığın şiddetinin belirlenmesine bağlıdır. Akut pankreatit şiddetinin belirlenmesi, klinik komplikasyonların öngörülmesi ve potansiyel ölüm riskinin saptanması için çok önemlidir. Akut biliyer pankreatitli hastalarda pankreatit şiddetini belirlemek ve hastaların takiplerinde kullanılmak üzere APACHE II, Ranson ve Balthazar skorlama sistemlerinin morbidite tahminindeki etkinliklerini ve varsa birbirlerine üstünlüklerini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: 2009 - 2011 yılları arasında kliniğimize başvuran 131 akut biliyer pankreatitli hasta prospektif araştırıldı. Hastaların APACHE II, Ranson ve Balthazar şiddet skorları belirlendi. BULGULAR: Hastaların 51’inde (%38.9) lokal, 68’inde (%51.9) sistemik komplikasyon olmak üzere toplam 77 hastada (%58.8) morbidite geliştiği gözlendi. APACHE II skoruna göre 61 (%46.6), Ranson skoruna göre 77 (%58.8), Balthazar skoruna göre 58 (%44.3) hastada şiddetli pankreatit saptandı. TARTIŞMA ve SONUÇ: APACHE II, Ranson ve Balthazar skorlama sistemlerinin akut biliyer pankreatit hastalarının morbidite tahmininde etkin olduğu ancak Balthazar skorlama sisteminin morbidite ve lokal komplikasyon tahmininde, APACHE II skorlama sisteminin ise sistemik komplikasyon tahmininde diğer skorlama sistemlerinden daha etkin olduğu saptandı.

The Role of Apache II, Ranson and Balthazar Scoring Systems on Morbitidy in Patients with Acute Biliary Pancreatitis

INTRODUCTION: The treatment of patients diagnosed with acute pancreatitis depends on the severity of the disease. The severity of acute pancreatitis is very important for predicting clinical complications and for identifying potential risk of death. OBJECTİVE:We aimed to investigate the efficacy of APACHE II, Ranson and Balthazar scoring systems on morbidity estimation and their superiority to each other in order to determine the severity of pancreatitis in patients with acute biliary pancreatitis. METHODS: We prospective investigated 131 consecutive patients with acute biliary pancreatitis between 2009 and 2011. APACHE II, Ranson and Balthazar severity scores were determined. RESULTS: We observed totally 77 of the patients ( % 58.8 ) with complications, ın turn, 51 of the patients ( %38.9 )were local and 68 ( % 51.9 ) had systemic complications. We determined patients with severe pancreatitis according of the APACHE II, Ranson and Balthazar scores respectively, 61 (%46.6), 77 (%58.8), göre 58 (%44.3). DISCUSSION AND CONCLUSION: APACHE II, Ranson and Balthazar scoring systems were found to be effective in predicting morbidity of patients with acute biliary pancreatitis but Balthazar scoring system was found to be more effective in predicting morbidity and local complications, and APACHE II scoring system was more effective in predicting systemic complications than other scoring systems.

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