TITLE

The early prediction of mortality in acute pancreatitis: a large population-based study

AUTHOR(S)
Wu, B U; Johannes, R S; Sun, X; Tabak, Y; Conwell, D L; Banks, P A
PUB. DATE
December 2008
SOURCE
Gut;Dec2008, Vol. 57 Issue 12, p1698
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Identification of patients at risk for mortality early in the course of acute pancreatitis (AP) is an important step in improving outcome. Methods: Using Classification and Regression Tree al (CART) analysis, a clinical scoring system was developed for prediction of in-hospital mortality in AP. The scoring system was derived on data collected from 17992 cases of AP from 212 hospitals in 2000-2001. The new scoring system was validated on data collected from 18256 AP cases from 177 hospitals in 2004-2005. The accuracy of the scoring system for prediction of mortality was measured by the area under the receiver operating characteristic curve )AUC). The performance of the new scoring system was further validated by comparing its predictive accuracy with that of Acute Physiology and Chronic Health Examination (APACHE) II. Results: CART analysis identified five variables for prediction of in-hospital mortality. One point is assigned for the presence of each of the following during the first 24 h: blood urea nitrogen (BUN) >25 mg/dl; impaired mental status; systemic inflammatory response syndrome (SIRS); age >60 years; or the presence of a pleural effusion (BISAP). Mortality ranged from >20% in the highest risk group to <1% in the lowest risk group. In the validation cohort, the BISAP AUC was 0.82 (95% CI 0.79 to 0.84) versus APACHE II AUC of 0.83 )95% Cl 0.80 to 0.85). Conclusions: A new mortality-based prognostic scoring system for use in AP has been derived and validated. The BISAP is a simple and accurate method for the early identification of patients at increased risk for in-hospital mortality.
ACCESSION #
35718733

 

Related Articles

  • An unusual cause of pleural effusion, urinothorax in a child with urinary stone disease. Buyukcelik, Mithat; Satar, Nihat; Celik, Umit; Yildizdas, Dincer; Dursun, Hasan; Soran, Musafa; Anarat, Ali // Pediatric Nephrology;Oct2005, Vol. 20 Issue 10, p1487 

    The association of obstructive uropathy with ascites has been known since 1863 and with pleural effusion since 1954. Urinothorax is a rare complication of blunt renal trauma, ureteral instrumentation or ureteral surgery. Leakage from the urinary tract may cause urinoma, retroperitoneal...

  • Electronic endoscope insertion into a thoracic drainage tube is a new technique in the treatment and diagnosis of pleural diseases. Zhi-Tian Wang; Lu-Ming Wang; Sun Li; Hu Jian // Surgical Endoscopy;Jul2009, Vol. 23 Issue 7, p1671 

    Pleural disease remains a commonly encountered clinical problem for both physician and surgeon. This study describes a new way to better diagnose and treat pleural diseases (hemothorax, empyema, and pleural effusion) using an electronic endoscope (gastroscope or bronchoscope). We conducted a...

  • Pleural Effusions: Stability of Samples for White Blood Cell and Differential Counts. Celia Garlipp; Paula Bottini; Maria Souza; Deize Silva; Cassiana Denardi; Marco Moda // Laboratory Medicine;Nov2007, Vol. 38 Issue 11, p685 

    Background: Generally, the pleural fluid specimen should arrive promptly in the laboratory and be analyzed as soon as possible, and its preservation has always been a major problem. In this study, the authors evaluated the stability of pleural fluid samples for white blood cell (WBC) and...

  • Pleural and pericardial morbidity after minimal access repair of pectus excavatum. Castellani, C.; Saxena, A. K.; Zebedin, D.; Hoellwarth, M. E. // Langenbeck's Archives of Surgery;Sep2009, Vol. 394 Issue 4, p717 

    The aim of this study was to evaluate the pleural and pericardial morbidity in patients that had undergone pectus excavatum corrections using minimal access repair of pectus excavatum (MARPE) at a single center. Data from patients after MARPE from 2000 to 2007 were prospectively collected....

  • Potential role of matrix metalloproteinase-2,-9 and tissue inhibitors of metalloproteinase-1,-2 in exudative pleural effusions. Vatansever, S.; Gelisgen, R.; Uzun, H.; Yurt, S.; Kosar, F. // Clinical & Investigative Medicine;Aug2009, Vol. 32 Issue 4, pE293 

    Purpose: To investigate diagnostic values of pleural fluid matrix metalloproteinase-2 (MMP-2), MMP-9, tissue inhibitors of metalloproteinase-1 (TIMP-1) and TIMP-2 measurements in tuberculous pleurisy(TP) and malignat pleurisy (MP). Methods: The study included 24 patients with TP, 22 patients...

  • Pleuropulmonary Blastoma: A Case Report. Hammad, Abdelmohsen M.; Serag, Amr R.; Bayoumi, Shereif L. // Internet Journal of Thoracic & Cardiovascular Surgery;2003, Vol. 6 Issue 2, p90 

    Pleuropulmonary blastoma (PPB) is a rare and aggressive malignant tumor that affects children. We present a case of pleuropulmonary blastoma in a 16-month-old male baby who was referred to our department due to apparently right side encysted pleural effusion. Chest CT depicted a large cystic...

  • The Occurrence Of Pleural Effusion Secondary To Ovarian Fibroma. Kant, Surya; Verma, Sanjay Kumar; Verma, Rajendra // Internet Journal of Pulmonary Medicine;2009, Vol. 10 Issue 2, p7 

    The association of pleural effusion and ascitis, secondary to ovarian tumor, are considered to be uncommon clinical condition. Hereby we reported a case of 43 years old female presented as right sided pleural effusion and ascitis secondary to ovarian fibroma and after removal of ovarian tumor...

  • Pleural effusion - An unusual cause. Vinoth, Ponnurangam Nagarajan; Anitha, Palaniyadi; Muthamilselvan, Sathyamoorthi; Sasitharan, Rajendraprasath; Shuba, Sankaranarayan; Rajakumar, Padur Sivaraman; Scott, Julius Xavier // Australasian Medical Journal;2012, Vol. 5 Issue 7, p113 

    Hepatitis A (HAV) infection is one of the most common forms of hepatitis in the paediatric age group in developing countries. It is usually self-limiting and rarely accompanied by extra hepatic complication. In this article, we report two children with hepatitis A who had associated issues of...

  • Cytopathologic Diagnosis in Pleural Effusion and Cyto-Histopathologic Correlation. Dağli, Adile Ferda; Küçük, Şirin; Sezer, Müge; Üçer, Özlem // Turkish Journal of Pathology;2011, Vol. 27 Issue 1, p12 

    Objective: Cytological examination of pleural fluids is a fast, efficient and non-invasive diagnostic method. Identification of malignant effusions bears critical importance in treatment and prognosis. The aim of this study was to investigate the distribution of cytopathologic diagnoses in...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics