ÇOK FAKTÖRLÜ PROGNOSTÝK KRÝTERLERÝN AKUT PANKREATÝT AÐIRLIÐINI BELÝRLEME KAPASÝTELERÝ

Aðýr akut pankreatitin belirlenmesinin tedavi ve prognoz açýsýndan büyük önemi vardýr. Geçen altý yýl içinde kliniðimizde tedavi edilen 120 hastada 122 akut pankreatit ataðýnda RANSON, IMRIE, BANK, AGARWAL tarafýndan tanýmlanan prognostik sistemlere bakýlarak, bu dört sistemin pakreatit aðýrlýðýný ve prognozunu belirleme kapasiteleri araþtýrýlmýþtýr. 120 hastanýn 79'u kadýn, 43'ü erkektir. 122 ataðýn 21'i (%17.2) aðýr, 101'i (%82.8) hafif þiddette pankreatittir. Bu dört sistemin aðýr akut pankreatiti belirlemedeki sensitivitesi sýrasýyla %85.7, %76.2, %66.7, %71.4'tür. Spesivite ise %86.1, %84.1, %80.2, %82.2 olarak bulunmuþtur. Sonuç olarak, 'pankreatit aðýrlýðýný ve prognozunu belirleme kapasiteleri yönünden bu dört sistem arasýnda büyük bir fark bulunmamakla birlikte; Ranson ve Ýmrie kriterlerinin daha duyarlý olduklarýný söyleyebiliriz.

THE CAPACITY OF MULTIFACTOR PROGNOSTIC SCORING SYSTEMS IN THE PREDICTION OF SEVERITY IN ACUTE PANCREATITIS

Early assessment of severe pancreatitis is of major importance in the treatment and prognostic evaluation. The prediction of severity and prognostic capacity of RANSON, IMRIE, BANK and AGARWAL scoring systems were analyzed in a consecutive series of 120 cases presented with 122 acute attacks during the previous 6 years. 79 patients were female and 43 were male. Of the 122 attacks, 21 were severe (17.2%) and 101 were mild pancreatitis (82.8). The sensitivity of these four systems in assessment of severe pancreatitis were 85.7%, 76.2%, 66.7% and 71.4% respectively. The specificity was found to be 96.1%, 94.1%, 80.2% and 82.2% respectively. Although no statistically significant difference in the assesment of disease severity and prognostic capacity was observed between the groups; there existed a statistical trend in sensivity favoring Ranson and Imrie scoring systems.