Yoğun Bakım Ünitelerinde Takip Edilen Akut Pankreatit Olgularının Apache-II Skorlarına Göre Akut Faz Reaktan ve Biyokimyasal Parametrelerinin Değişimi 5 Yıllık-2 Merkezli Retrospektif Analiz

Year 2019, Volume: 5 Issue: 1, 80 - 85, 01.01.2019

Memduh Şahin Eyüp Ekici

Abstract

Amaç: Pankreasın inflamatuvar bozukluğu olan akut pankreatit günümüzde en sık gastrointestinal kaynaklı hastaneye yatış nedenleri arasında yer almaktadır. Çalışmamızda yoğun bakımda yatırılan akut pankreatit hastalarının tanı anındaki Apache-II skorlarına göre akut faz reaktanları ve biyokimyasal parametrelerinin değişimini değerlendirmek amaçlanmıştır.Gereç ve Yöntemler: Yoğun bakım ünitesinde yatmış olan akut pankreatit tanılı 79 hastanın tanı anındaki laboratuvar değerleri C-reaktif protein, sedimentasyon ve biyokimyasal parametreler analiz edildi. Apache-II skorları hesaplandı. Apache-II skoru iki gruba ayrılarak skor

Keywords

Akut pankreatit, Akut faz, Apache-2

Change of Acute Phase Reactants and Biochemical Parameters According to Apache-II Scores of Cases with Acute Pancreatitis Followed up in Intensive Care Units 5 Year-2 Center Retrospective Data Analysis

Abstract

Objective: Acute pancreatitis, which is an inflammatory disorder of the pancreas, is one of the most common causes of gastrointestinal hospitalization. In our study, we tried to investigate the association of Apache-II scoring system with diagnostic acute phase reactants and biochemical markers used in acute pancreatitis patients admitted to Intensive Care Units.Material and Methods: In our study, 79 acute pancreatitis patient and the values of the patients hospitalized in the Intensive Care Units were analyzed. Apache-II scores were calculated in the presence of C-reactive protein, sedimentation, and biochemical parameters in all patients. In our study, we compared two groups with Apache-II score of equal to and above 9 Group B and below 9 Group A , according to the Apache-II score.Results: In group B, Lactate Dehydrogenase LDH , glucose and leucocyte values were found to be higher than in group A patients, but amylase was lower in group A patients. In females, leukocyte and AST values were higher than in males. At the time of admission, Apache-II scores in males were higher than in female patients. In 79 pancreatic patients, C-reactive protein CRP was correlated with Apache-II scores. In our study, amylase p = 0.032 , creatinine p = 0.006 and AST 0.25 values were found to affect Apache-II group values in logistic regression analysis in terms of A and B groups for Apache-II. Conclusion: The Apache-II scores are an evaluation parameter that has an important place in acute pancreatitis cases following intensive care and gives results related to acute phase reactants

Keywords

Acute pancreatitis, Acute phase, Apache-2

References

• Teshima CW, Bridges RJ, Fedorak RN.Canadian Digestive Health Foundation Public Impact Series 5: Pancreatitis in Canada. Incidence, prevalence, and direct and indirect economic impact. Can J Gastroenterol 2012; 26(8):544-5.
• Lippi G, Valentino M, Cervellin G. Laboratory diagnosis of acute pancreatitis: In search of the Holy Grail. Crit Rev Clin Lab Sci 2012; 49(1):18-31.
• Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet 2015; 386(9988):85-96.
• Wang X, Cui Z, Zhang J, Li H, Zhang D, Miao B, Cui Y, Zhao E, Li Z, Cui N. Early predictive factors of in hospital mortality in patients with severe acute pancreatitis. Pancreas 2010; 39(1):114-5.
• Schütte K1, Malfertheiner P. Markers for predicting severity and progression of acute pancreatitis. Best Pract Res Clin Gastroenterol 2008; 22(1):75-90.
• Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Localio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol 1974; 61(6):443-51.
• Yeung YP, Lam BY, Yip AW. APACHE system is better than Ranson system in the prediction of severity of acute pancreatitis. Hepatobiliary Pancreat Dis Int 2006; 5(2):294-9.
• Knaus WA, Draper EA, Wagner DP, Wagner DP. APACHE II: A severity of disease classification system. Crit Care Med 1985; 13(10):818-29.
• Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet 1989; 22:2201-5.
• Toh SK, Phillips S, Johnson CD. A prospective audit against national standards of the presentation and management of acute pancreatitis in the South of England. Gut 2000; 46:239-43.
• Kaya E, Dervisoglu A, Polat C. Evaluation of diagnostic findings and scoring systems in outcome prediction in acute pancreatitis. World J Gastroenterol 2007; 13(22):3090-4.
• Gürleyik G, Emir S, Kiliçoglu G, Arman A, Saglam A. Computed tomography severity index, APACHE II score, and serum CRP concentration for predicting the severity of acute pancreatitis. JOP 2005; 6(6):562-7.
• Thandassery RB, Yadav TD, Dutta U, Appasani S, Singh K, Kochhar R. Hypotension in the first week of acute pancreatitis and APACHE II score predict development of infected pancreatic necrosis. Dig Dis Sci 2015; 60(2):537- 42.