急性胰腺炎的预后-POP评分幻灯片.pptVIP

Problem Collected several decades ago Containing a small proportion of patients with severe acute pancreatitis Take 48h to complete Do not have a high degree of sensitivity and specificity the data set was not collected for the purpose of identifying patients with pancreatitis. It was therefore not possible to validate the diagnosis of pancreatitis (e.g., based on amylase levels or computed tomography scans) or to evaluate all potential prognostic variables (e.g., serum lactate dehydrogenase as was included in the modified Glasgow criteria). Other pertinent details, such as the etiology of the pancreatitis and comorbidities such as diabetes and nonsevere heart failure, are also missing. We also lack data collected at ICU admission for these patients to test the validity of the POP Score at this earlier time point. Thanks! * * The Pancreatitis Outcome Prediction (POP) Score: A new prognostic index for patients with severe acute pancreatitis Causes of acute pancreatitis Well-established causes Gallstones 40% Alcoholism 35% Hypertriglyceridemia Post–endoscopic retrograde cholangiopancreatography Drug induced Autoimmune Genetic Abdominal trauma Postoperative Ischemia Infections Hypercalcemia and hyperparathyroidism Scorpion venom Pancreas divisum with ductular narrowing on pancreatogram Idiopathic Controversial causes Sphincter of Oddi dysfunction Pancreas divisum without ductal narrowing on pancreatogram Microlithiasis/sludge Epidemiology Incidence:varies from 4.8 to 24.2 per 100,000 in England,Denmark,and the United States Up to 20% of patients with acute pancreatitis will develop severe pancreatitis Overall mortality is reported as 10% to 15% mild acute pancreatitis: 5% severe acute pancreatitis:20% to 25% Cause of death first two weeks: due to systemic inflammatory response syndrome and orgen failure after two weeks: due to sepsis and its complications Accurate predictors of the severity of acute pancreatitis ar