BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizin...BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.展开更多
背景 高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)需要早期识别其潜在的致命性并发症,研究已表明急性胰腺炎严重程度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分与这些并发症相关.目的 ...背景 高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)需要早期识别其潜在的致命性并发症,研究已表明急性胰腺炎严重程度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分与这些并发症相关.目的 通过Meta分析评估BISAP评分对HLAP严重性的预测价值.方法 检索国内外主要数据库,收集BISAP评分预测HLAP严重性的研究,用Stata及Meta-disc软件行Meta分析.结果 本Meta纳入10篇文章(n=1591).BISAP评分≥3分预测HLAP发生死亡的总敏感性、特异性、曲线下面积(area under curve,AUC)、诊断比值比(diagnostic odds ratio,DOR)分别为0.85(95%CI:0.65-0.96)、0.86(95%CI:0.82-0.88)、0.937、42.00(95%CI:12.86-139.12).BISAP评分升高预测HLAP发生重症急性胰腺炎(severe acute pancreatitis,SAP)的总敏感性、特异性、AUC、DOR分别为0.69(95%CI:0.61-0.76)、0.82(95%CI:0.78-0.85)、0.900、18.47(95%CI:6.82-42.03);预测中重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)+SAP的总敏感性、特异性、AUC、DOR分别为0.54(95%CI:0.50-0.63)、0.91(95%CI:0.89-0.93)、0.724、15.55(95%CI:6.91-34.99).BISAP评分与急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、Ranson评分相比,结合自身优点,预测HLAP严重性更具优势.结论 BISAP评分是预测HLAP严重性的有利工具,但预测SAP、MSAP+SAP的敏感性偏低.展开更多
基金the Science and Technology Program of Guiyang Baiyun District Science and Technology Bureau.No.[2017]50Science and Technology Program of Guiyang Municipal Bureau of Science and Technology,No.[2018]1-72Science and Technology Fund Project of Guizhou Provincial Health Commission,No.gzwkj2021-127.
文摘BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.
文摘背景 高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)需要早期识别其潜在的致命性并发症,研究已表明急性胰腺炎严重程度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分与这些并发症相关.目的 通过Meta分析评估BISAP评分对HLAP严重性的预测价值.方法 检索国内外主要数据库,收集BISAP评分预测HLAP严重性的研究,用Stata及Meta-disc软件行Meta分析.结果 本Meta纳入10篇文章(n=1591).BISAP评分≥3分预测HLAP发生死亡的总敏感性、特异性、曲线下面积(area under curve,AUC)、诊断比值比(diagnostic odds ratio,DOR)分别为0.85(95%CI:0.65-0.96)、0.86(95%CI:0.82-0.88)、0.937、42.00(95%CI:12.86-139.12).BISAP评分升高预测HLAP发生重症急性胰腺炎(severe acute pancreatitis,SAP)的总敏感性、特异性、AUC、DOR分别为0.69(95%CI:0.61-0.76)、0.82(95%CI:0.78-0.85)、0.900、18.47(95%CI:6.82-42.03);预测中重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)+SAP的总敏感性、特异性、AUC、DOR分别为0.54(95%CI:0.50-0.63)、0.91(95%CI:0.89-0.93)、0.724、15.55(95%CI:6.91-34.99).BISAP评分与急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、Ranson评分相比,结合自身优点,预测HLAP严重性更具优势.结论 BISAP评分是预测HLAP严重性的有利工具,但预测SAP、MSAP+SAP的敏感性偏低.
