Early Recognition of Pediatric Venous Thromboembolism: A Risk-Assessment Tool

2012 ◽  
Vol 21 (3) ◽  
pp. 178-184 ◽  
Author(s):  
Andrea S. Prentiss
Keyword(s):  
Venous Thromboembolism ◽  
Risk Score ◽  
Lupus Erythematosus ◽  
Assessment Tool ◽  
Early Recognition ◽  
Reliability And Validity ◽  
Adverse Outcomes ◽  
P Value ◽  
Early Assessment ◽  
Patients At Risk

Background The incidence of venous thromboembolism in children has increased dramatically, with most cases occurring in children with cancer, surgery, trauma, congenital heart disease, and systemic lupus erythematosus. Early assessment of risk factors present in children would minimize morbidity and mortality from these events. Objectives To evaluate the reliability and validity of a tool for assessing risk for venous thromboembolism in children. Methods The tool was developed after a review of the literature with assessment of content validity by a multidisciplinary team of experts. Patients’ charts were reviewed retrospectively to establish reliability and validity of the tool. A P value less than .05 was considered statistically significant. Results Thirty-five charts were assessed for tool validity and were found to be statistically significant for all 3 risk score assessment categories. Logistic regression was used to assess 1001 patients’ charts for internal consistency, which was found to be high (χ25[n = 1001] = 100.6, P < .001). Results indicated that most patients at risk for venous thromboembolism were between the ages of 13 and 17 years, with females having more than 7 times greater risk than males. Conclusions Descriptive statistics show that the assessment tool displays strong reliability and validity. Results validated a significant relationship between the risk score and the incidence of venous thromboembolism. Findings suggest that use of the assessment tool could significantly reduce adverse outcomes associated with venous thromboembolism in children.

Multicentre validation of the Geneva Risk Score for hospitalised medical patients at risk of venous thromboembolism

2014 ◽  
Vol 111 (03) ◽  
pp. 531-538 ◽  
Author(s):  
Drahomir Aujesky ◽  
Daniel Hayoz ◽  
Jürg Beer ◽  
Marc Husmann ◽  
Beat Frauchiger ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Risk Score ◽  
Primary Endpoint ◽  
Low Risk ◽  
Prediction Score ◽  
Medical Patients ◽  
Cumulative Rate ◽  
Patients At Risk ◽  
Risk Patients

SummaryThere is a need to validate risk assessment tools for hospitalised medical patients at risk of venous thromboembolism (VTE). We investigated whether a predefined cut-off of the Geneva Risk Score, as compared to the Padua Prediction Score, accurately distinguishes low-risk from high-risk patients regardless of the use of thromboprophylaxis. In the multicentre, prospective Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE) cohort study, 1,478 hospitalised medical patients were enrolled of whom 637 (43%) did not receive thromboprophylaxis. The primary endpoint was symptomatic VTE or VTE-related death at 90 days. The study is registered at ClinicalTrials.gov, number NCT01277536. According to the Geneva Risk Score, the cumulative rate of the primary endpoint was 3.2% (95% confidence interval [CI] 2.2–4.6%) in 962 high-risk vs 0.6% (95% CI 0.2–1.9%) in 516 low-risk patients (p=0.002); among patients without prophylaxis, this rate was 3.5% vs 0.8% (p=0.029), respectively. In comparison, the Padua Prediction Score yielded a cumulative rate of the primary endpoint of 3.5% (95% CI 2.3–5.3%) in 714 high-risk vs 1.1% (95% CI 0.6–2.3%) in 764 lowrisk patients (p=0.002); among patients without prophylaxis, this rate was 3.2% vs 1.5% (p=0.130), respectively. Negative likelihood ratio was 0.28 (95% CI 0.10–0.83) for the Geneva Risk Score and 0.51 (95% CI 0.28–0.93) for the Padua Prediction Score. In conclusion, among hospitalised medical patients, the Geneva Risk Score predicted VTE and VTE-related mortality and compared favourably with the Padua Prediction Score, particularly for its accuracy to identify low-risk patients who do not require thromboprophylaxis.

scholarly journals POS0764 EULAR RECOMMENDATION-BASED QUALITY INDICATORS (QIS) FOR SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): ELABORATION, FINAL SET, PERFORMANCE AND INITIAL VALIDATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 635.2-636
Author(s):  
K. Chavatza ◽  
M. Kostopoulou ◽  
D. Nikolopoulos ◽  
O. Gioti ◽  
K. Togia ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Adverse Outcomes ◽  
P Value ◽  
Sustained Remission ◽  
Systemic Lupus ◽  
Eular Recommendations ◽  
Work Up

Background:Targets of therapy and quality of care are receiving increased attention in systemic lupus erythematosus (SLE).Objectives:To develop Quality Indicators (QIs) for the care of SLE patients based on the EULAR recommendations, and assess their performance.Methods:Using the published EULAR recommendations for SLE, we developed 44 candidate QIs. These were independently rated for validity and feasibility by 12 experts, analysed by a modified RAND/UCLA model and further scrutinized based on the scorings and expert opinion. (Fig.1) Adherence to the final set of QIs was tested in a cohort of 220 SLE patients combined with an assessment on its impact on disease outcomes such as flares, hospitalizations and organ damage.Results:The panel rated 18 QIs as valid and feasible. These involve diagnosis; disease and damage assessment; monitoring for lupus nephritis and drug toxicity; therapy and targets of therapy; fertility and pregnancy; and adjunct therapy (preventive measures for osteoporosis, vaccination, cardiovascular disease). On average, SLE patients received 54% (95%CI 52–56%) of the indicated care with adherence ranging from 41% for QIs related to monitoring to 88% for treatment-related QIs. Regarding targets of therapy, sustained remission or low disease activity were achieved in 27%, while 94% of patients received low-dose glucocorticoids, and 92% the recommended hydroxychloroquine dose. Dependent upon individual QI tested, adherence for lupus nephritis-related QIs was 88% for receiving appropriate adjunct therapy (ACE inhibitors) to 100% for being treated with the indicated immunosuppressive treatment. In contrast, adherence to QIs related to preventive measures and other adjunct therapies was moderate to low. Notably, patients who were eligible for cardiovascular risk modification, vaccination, and osteoporosis management received lower quality of care (40.5%, 47.7% and 45.5% respectively) while 91.4% had sunscreen protection. In reference to laboratory work-up and monitoring, complete laboratory work-up at diagnosis was performed in 48%, while disease activity and damage, were fully assessed only in 14.1% (in three consecutive visits) and 28.6% (annually) respectively, Similarly, reproductive health and pregnancy counselling adherence rates were modest estimated at 50% and 62% respectively. Higher adherence to the indicated care during follow-up (monitoring QIs) was associated with reduced risk for adverse outcomes during the last year of observation (OR 0.97, 95%CI 0.96-0.99). Patients who achieved sustained remission or LLDAS, exhibited fewer flares (OR=0.15, p-value<0.001) and damage accrual (OR=0.35, p-value<0.001). Of interest, patients who received low-dose of GCs or were appropriately vaccinated, had a lower risk of experiencing a flare (OR=0.23 and 0.46 respectively).Conclusion:A set of 18 QIs based on the EULAR recommendations for SLE was developed to be used towards improving care in SLE. Initial real-life data suggest variable degree of adherence with higher adherence resulting in reduced adverse outcomes.References:[1]Fanouriakis, et al., 2019 Update of the EULAR recommendations for the management of systemic lupus erythematosus. In Annals of the Rheumatic Diseases (Vol. 78, Issue 6, pp. 736–745). BMJ Publishing Group. https://doi.org/10.1136/annrheumdis-2019-215089.[2]Nikolopoulos, D., et al., Evolving phenotype of systemic lupus erythematosus in Caucasians: low incidence of lupus nephritis, high burden of neuropsychiatric disease and increased rates of late-onset lupus in the ‘Attikon’ cohort. Lupus, 29(5), 514–522. https://doi.org/10.1177/0961203320908932.Acknowledgements:This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 742390)Disclosure of Interests:None declared

scholarly journals N-PASS Versus mPAT in Assessment and Management of Neonatal Pain at Neonatal ICUs in Palestine

2019 ◽  
Vol 4 (06) ◽  
Author(s):  
Khamis Elessi ◽  
Shireen Abed ◽  
Tayseer Jamal Afifi ◽  
Rawan Utt ◽  
Mahmood Elblbessy ◽  
...  
Keyword(s):  
Pain Score ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Disease Process ◽  
Reliability And Validity ◽  
Internal Consistency Reliability ◽  
Assessment Tools ◽  
Therapeutic Interventions ◽  
P Value ◽  
Neonatal Pain

Background: Neonates frequently experience pain as a result of diagnostic or therapeutic interventions or as a result of a disease process. Neonates cannot verbalize their pain experience and depend on others to recognize, assess and manage their pain. Neonates may suffer immediate or long-term consequences of unrelieved pain. Accurate assessment of pain is essential to provide adequate management. Observational scales, which include physiological and behavioral responses to pain, are available to aid consistent pain management. Pain assessment is considered as the fifth vital sign. Objectives: Aims of the present study were (1) to compare two commonly cited neonatal pain assessment tools, Neonatal Pain, Agitation and Sedation Scale (N-PASS) and modified Pain Assessment Tool (mPAT), with regard to their psychometric qualities, (2) to explore intuitive clinicians' ratings by relating them to the tools' items and (3) to ensure that neonates receive adequate pain control. Methods: Two coders applied both pain assessment tools to 850 neonates while undergoing a painful or a stressful procedure. Each neonate was assessed before, during and after the procedure. The evaluation before and after the procedure was done using NPASS, while pain score during the procedure was assessed by mPAT. Analyses of variances and regression analyses were used to investigate whether tools could discriminate between the procedures and whether tools' items were predictors of pain severity. Results: Internal consistency, reliability and validity were high for both assessment tools. N-PASS tool discriminated between painful and stressful situations better than mPAT. There was no relation between the age of neonate and the pain score. Moreover, P-value was statistically significant between mPAT score and post procedural assessment score as well as between pre and post procedural assessment scores. Conclusion: Both assessment tools performed equally well regarding physiologic parameters. However, N-PASS makes it possible to assess pain during sedation. It was noticed that gaps exist between practitioner knowledge and attitude regarding neonatal pain.

scholarly journals Higher albumin levels on admission predict better prognosis in patients with confirmed COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248358
Author(s):  
Matthew Kheir ◽  
Farah Saleem ◽  
Christy Wang ◽  
Amardeep Mann ◽  
Jimmy Chua
Keyword(s):  
Venous Thromboembolism ◽  
Adverse Events ◽  
Serum Albumin ◽  
Predictive Biomarker ◽  
Albumin Level ◽  
Adverse Outcomes ◽  
Adjusted Relative Risk ◽  
Radiologic Imaging ◽  
Patients At Risk ◽  
Polymerase Chain

Background Research surrounding COVID-19 (coronavirus disease 2019) is rapidly increasing, including the study of biomarkers for predicting outcomes. There is little data examining the correlation between serum albumin levels and COVID-19 disease severity. The purpose of this study is to evaluate whether admission albumin levels reliably predict outcomes in COVID-19 patients. Methods We retrospectively reviewed 181 patients from two hospitals who had COVID-19 pneumonia confirmed by polymerase chain reaction (PCR) testing and radiologic imaging, who were hospitalized between March and July 2020. We recorded demographics, COVID-19 testing techniques, and day of admission labs. The outcomes recorded included the following: venous thromboembolism (VTE), acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, discharge with new or higher home oxygen supplementation, readmission within 90 days, in-hospital mortality, and total adverse events. A multivariate modified Poisson regression analysis was then performed to determine significant predictors for increased adverse events in patients with COVID-19 pneumonia. Results A total of 109 patients (60.2%) had hypoalbuminemia (albumin level < 3.3 g/dL). Patients with higher albumin levels on admission had a 72% decreased risk of developing venous thromboembolism (adjusted relative risk [RR]:0.28, 95% confidence interval [CI]:0.14–0.53, p<0.001) for every 1 g/dL increase of albumin. Moreover, higher albumin levels on admission were associated with a lower risk of developing ARDS (adjusted RR:0.73, 95% CI:0.55–0.98, p = 0.033), admission to the ICU (adjusted RR:0.64, 95% CI:0.45–0.93, p = 0.019), and were less likely to be readmitted within 90 days (adjusted RR:0.37, 95% CI:0.17–0.81, p = 0.012). Furthermore, higher albumin levels were associated with fewer total adverse events (adjusted RR:0.65, 95% CI:0.52–0.80, p<0.001). Conclusions Admission serum albumin levels appear to be a predictive biomarker for outcomes in COVID-19 patients. We found that higher albumin levels on admission were associated with significantly fewer adverse outcomes, including less VTE events, ARDS development, ICU admissions, and readmissions within 90 days. Screening patients may lead to early identification of patients at risk for developing in-hospital complications and improve optimization and preventative efforts in this cohort.

scholarly journals Objective Assessment of Microsurgery Competency—In Search of a Validated Tool

2019 ◽  
Vol 52 (02) ◽  
pp. 216-221
Author(s):  
Sheeja Rajan ◽  
Ranjith Sathyan ◽  
L. S. Sreelesh ◽  
Anu Anto Kallerey ◽  
Aarathy Antharjanam ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Convergent Validity ◽  
Assessment Tool ◽  
Objective Assessment ◽  
Reliability And Validity ◽  
Assessment Tools ◽  
Skill Assessment ◽  
P Value ◽  
Global Rating ◽  
Skills Acquisition

AbstractMicrosurgical skill acquisition is an integral component of training in plastic surgery. Current microsurgical training is based on the subjective Halstedian model. An ideal microsurgery assessment tool should be able to deconstruct all the subskills of microsurgery and assess them objectively and reliably. For our study, to analyze the feasibility, reliability, and validity of microsurgery skill assessment, a video-based objective structured assessment of technical skill tool was chosen. Two blinded experts evaluated 40 videos of six residents performing microsurgical anastomosis for arteriovenous fistula surgery. The generic Reznick's global rating score (GRS) and University of Western Ontario microsurgical skills acquisition/assessment (UWOMSA) instrument were used as checklists. Correlation coefficients of 0.75 to 0.80 (UWOMSA) and 0.71 to 0.77 (GRS) for interrater and intrarater reliability showed that the assessment tools were reliable. Convergent validity of the UWOMSA tool with the prevalidated GRS tool showed good agreement. The mean improvement of scores with years of residency was measured with analysis of variance. Both UWOMSA (p-value: 0.034) and GRS (p-value: 0.037) demonstrated significant improvement in scores from postgraduate year 1 (PGY1) to PGY2 and a less marked improvement from PGY2 to PGY3. We conclude that objective assessment of microsurgical skills in an actual clinical setting is feasible. Tools like UWOMSA are valid and reliable for microsurgery assessment and provide feedback to chart progression of learning. Acceptance and validation of such objective assessments will help to improve training and bring uniformity to microsurgery education.

scholarly journals The Burnout Assessment Tool (BAT): A Contribution to Italian Validation with Teachers’

2021 ◽  
Vol 13 (16) ◽  
pp. 9065
Author(s):  
Giacomo Angelini ◽  
Ilaria Buonomo ◽  
Paula Benevene ◽  
Piermarco Consiglio ◽  
Luciano Romano ◽  
...  
Keyword(s):  
Factor Structure ◽  
Prolonged Exposure ◽  
Assessment Tool ◽  
School Context ◽  
Adverse Outcomes ◽  
Assessment Tools ◽  
Stress Factors ◽  
Risk Level ◽  
P Value ◽  
Risk Levels

This study aims to validate the Burnout Assessment Tool (BAT) adapted to the Italian education sector. Teacher burnout is physical and emotional pain, due to prolonged exposure to school-related stress factors. Previous research has abundantly proven that preventive assessment of teachers’ risk level for burnout may reduce adverse outcomes. In this regard, new assessment tools, able to bring together evidence from fifty years of research on this topic, were mainly used to monitor burnout-risk levels in the school context. For the present work, 846 Italian teachers (Female, 91.1%; M age = 47.52; SD = 9.94) were involved in the study. Confirmatory factor analysis supported a four-factor structure for the core dimensions (BAT-C; exhaustion, mental distance, emotional impairment, cognitive impairment), and a two-factor structure for the secondary dimensions (BAT-S; psychological distress, psychosomatic complaints). The Italian version of the BAT-C and BAT-S has shown good internal consistency (respectively, α = 0.900 and ω = 0.913; α = 0.845 and ω = 0.857) and validity (all correlations between variables showed a p value < 0.01). Our findings support the Italian adaptation of the original version of the BAT as a valid instrument for measuring teachers’ burnout through principal and secondary symptoms.

scholarly journals Promoting Early Assessment of Frailty in the New Normal: An Updated eFI-CGA Software Tool

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 824-824
Author(s):  
Katayoun Sepehri ◽  
Hilary Low ◽  
Grace Park ◽  
Xiaowei Song
Keyword(s):  
Assessment Tool ◽  
Frailty Index ◽  
Software Tool ◽  
Primary Care Providers ◽  
Adverse Outcomes ◽  
Care Providers ◽  
Early Assessment ◽  
New Normal ◽  
Care Plans ◽  
Frailty Assessment

Abstract Frailty is a state of diminished physiological reserves. Being able to detect and manage frailty early is crucial for effective controlling of frailty-related adverse outcomes. Frailty can be assessed using the frailty index that counts the number of health deficits accumulated over time. Our previous research has enabled an electronic Comprehensive Geriatric Assessment (eCGA) and the calculation of the frailty index based on the eCGA (eFI-CGA). While the standalone eFI-CGA has been used by primary care providers in assessing home-living patients, its initial release was prior to the covid-19 pandemic; the associated new challenges were not targeted by the early version. In facilitating effective virtual assessment and care planning during the current “lockdown” and in the upcoming “new normal”, most recently the eFI-CGA version 3.0 was released. In this paper, we 1) introduce the updated electronic frailty assessment tool and its usage, 2) describe the major updates of the software in dealing with challenges due to social isolation and remote assessment, and 3) evaluate the end-user experience with the upgraded methods in frailty assessment. These new developments and implementations allowed a search function to resume disrupted assessment sessions and quickly retrieve previously saved assessment records. The improved user interface promoted the clinicians to conveniently record detailed care plans and management details. The study provided a successful example of moving from disruption to transformation, benefiting the highly demanded healthcare of older adults in this challenging time.

scholarly journals 103 The Characteristics of Frail Older Patients Admitted Through an Emergency Department, who Experience New Disability due to Acute Illness

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Sara Inglis ◽  
Siobhan Ryan ◽  
Jennifer Maher ◽  
Ciara Pender ◽  
Karen Sayers ◽  
...  
Keyword(s):  
Barthel Index ◽  
Older Patients ◽  
Assessment Tool ◽  
Functional Decline ◽  
P Value ◽  
Main Determinant ◽  
Patients At Risk ◽  
Interdisciplinary Assessment ◽  
Student’S T ◽  
Student’S T Test

Abstract Background No current tool reliably predicts functional decline risk. The modified Barthel Index (mBI) is a validated measure of disability, ideal for use within an interdisciplinary assessment. The aim of this prospective cohort study was to determine the proportion and characteristics of newly admitted frail older patients who experience drops in their Barthel index, requiring intervention. Methods Consecutive acute emergency patients identified as Variable Indicative of Placement positive at triage, were assessed using an interdisciplinary assessment tool (IAT), from February 1st 2019 to March 31st 2019. Data was entered into an excel database on demographics, baseline mBI and inpatient (within 72 hours) mBI, frailty-associated co-morbidities and multi-disciplinary interventions and analysed using Student’s T-test. Results 150 consecutive patients were assessed with a mean age (mean (+/- SD)) of 83.1(+/- 7.4). mBI scores were recorded for 111(74%) of patients. Mean mBI prior to current illness was 15.4(+/- 4.9). Post-illness mBI was 12.5(+/- 5.3). 65(58.6%) patients experienced an mBI drop. Mean drop was 4.9 (+/- 2.8) points. There was no difference in age or baseline mobility between those who either did or did not experience an mBI drop. Patients with a drop had higher mean pre-illness mBI (16.2 vs. 14.2; p-value 0.017, 4AT score (1.98 vs. 1.11; p-value 0.035) and increased falls history (40 vs. 18 patients; p-value <0.01), compared to patients with no drop. They required more referrals to the multidisciplinary team (3.7 vs. 2.9, p-value 0.002). Conclusion Higher proportions of frail patients experienced a drop in function compared with studies where age is used as a cut-off. Within this small frail patient cohort, age was surprisingly not associated with mBI drops. Using frailty as the main determinant for assessment rather than age, results in a different cohort of patients, at risk of functional decline. Future predictive tools should focus on frailty rather than on age.

scholarly journals S125. THE ROLE OF DUP, DUI AND POLYGENIC SCORE FOR SCHIZOPHRENIA ON COGNITION IN ATHENS FEP STUDY SAMPLE

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S82-S83
Author(s):  
Stefanos Dimitrakopoulos ◽  
Alex Hatzimanolis ◽  
Pentagiotissa Stefanatou ◽  
Lida-Alkisti Xenaki ◽  
Nikos Stefanis
Keyword(s):  
Risk Score ◽  
Cognitive Deficit ◽  
Assessment Tool ◽  
First Episode Psychosis ◽  
First Episode ◽  
P Value ◽  
Polygenic Risk Score ◽  
Inform Consent ◽  
Polygenic Risk ◽  
Episode Psychosis

Abstract Background It remains unclear which biological mechanisms affect neurocognition in first episode psychosis (FEP) patients. There is minimal evidence from current literature suggesting an association between duration of untreated psychosis (DUP) or duration of untreated illness (DUI) and cognitive decline in FEP patients. It is still controversial whether genetic factors, such as polygenic risk score for schizophrenia, determine observed cognitive deficits. The study of interplay between DUP, DUI and genetic risk factors might be important to understand underlying pathways. Methods Ninety FEP patients where recruited during Athens First-Episode Psychosis Research study between 2015–2018. All participants provided inform consent. DUP for each patient was defined by NOS-DUP (Nottingham onset schedule: modified DUP version) assessment tool and DUI was determined using the symptom onset in schizophrenia (SOS) inventory. DNA was collected in order to create polygenic risk score (PGC) for schizophrenia for each individual using SNPs selected according to the significance of their association with the phenotype at nominal p-value thresholds of 0,05. WAIS-IV total score and subscales, i.e. Verbal Comprehension (VC), Perceptual Reasoning (PR), Working Memory (WM), Processing Speed (PS) and moreover index differences between these 4 subscales were applied as a measure of cognitive deficit. Results Generalized linear model analysis, after adjustment for years of education and gender, found no significant main effect of DUP, DUI or PGC on any cognitive subscale. Furthermore, conducting an exploratory analysis for possible interactions between DUP/DUI and PGC (n=90), we found statistically significant findings of DUP x PGC (F=8,175, p=,005) and DUI x PGC (F=5,592, p=,021) for the cognitive variable of VC/WM difference. The interplay between DUP and PCG and DUI and PGC was associated with observed differences between VM and WM in our FEP sample. Discussion Our preliminary results are consistent with recent literature suggesting that neurocognition is not determined by DUP, DUI or PGC for schizophrenia. Novel approach based on WAIS-IV indexes of interest allows to explore subtle differences between cognitive subdomains. Elucidating underlying interplay between genetic and disease-related mechanisms could be important to understand the core feature of cognitive deficit in FEP patients.

scholarly journals Comparison between Ransons score and modified CTSI in predicting the severity of acute pancreatitis based on modified Atlanta classification 2012

2019 ◽  
Vol 6 (5) ◽  
pp. 1596
Author(s):  
Manjunath B. D. ◽  
Mohammed Arafath Ali ◽  
Abdul Razack ◽  
Harindranath H. R. ◽  
Avinash K. ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Severe Disease ◽  
P Value ◽  
Early Assessment ◽  
Idiopathic Pancreatitis ◽  
Severe Pancreatitis ◽  
Gall Stones ◽  
Patients At Risk ◽  
Multiorgan Dysfunction Syndrome

Background: Acute pancreatitis is an inflammatory process of the pancreas with possible peripancreatic tissue and multiorgan involvement inducing multiorgan dysfunction syndrome (MODS) with a high mortality rateand hence early identification of patients at risk for severe disease is of vital importance.Methods: Data were collected from 50 patients who presented to the emergency department of hospitals attached to BMCRI, Bangalore, having acute pancreatitis.Results: The study included 50 patients- 40 males and 10 females and median patient age was 54.5years.Out of the 50 patients, 40% had gall stones, 56% were alcoholic and 4% had idiopathic pancreatitis.56% were found to have a Ransons score of >3 and 44% had score < 3; 52%had a modified CTSI score of 0-2, 52%had a score of 4-6 and 22% had a score of 8-10. The incidence of severe acute pancreatitis in patients with Ransons score >3 has a p value <0.002. Also, the incidence of severe acute pancreatitis in patients with modified CTSI score >4 has a p value of <0.001.With respect to mortality, all 4 patients who died had a modified CTSI score of >4 (p=0.002) and 3 patients had Ransons score >3 (p=0.03) which is statistically significant.Conclusions: In our country where facility for CECT is not available to a major proportion of population, early assessment of severe pancreatitis can be performed by Ransons scoring, which is found to be comparable to modified CTSI scoring.

Sign in / Sign up

Export Citation Format

Share Document