ABSTRACT
Objective To explore the four criteria,including bedside index for severity in acute pancreatitis(BISAP),Ranson score,modified CT severity index(MCTSI) and acute physiology and chronic health evaluation scoring system Ⅱ (APACHE Ⅱ) in assessment of severity and prognosis of hyperlipidemic acute pancreatitis.Methods A total of 326 patients with hyperlipidemic acute pancreatitis were studied retrospectively from August 2006 to July 2015.The discrepancy of the four criteria in assessment of severity and prognosis of hyperlipidemic acute pancreatitis was compared with chi-square test and receiver operating characteristic curve.Results The incidences of moderately severe acute pancreatitis and severe acute pancreatitis,local complications and mortality of patients with BISAP score ≥3,Ranson score ≥3,APACHE Ⅱ score≥8 and MCTSI score≥4 were significantly higher than BISAP score ＜ 3,Ranson score ＜ 3,APACHE Ⅱ score ＜ 8 and MCTSI ＜ 4 respectively (all P ＜ 0.05).As far as severity was concerned,the sensitivity and AUC of APACHE Ⅱ were 57％ and 0.814,which were higher than the other systems.The second most sensitive criterion was BISAP.In assessment of local complications,the sensitivity and AUC of MCTSI were 68％ and 0.791,which were higher than the other three.The most sensitive criterion to predict mortality was BISAP with sensitivity 89％ and AUC 0.867,which was followed by APACHE Ⅱ.Conclusions All four criteria can be used to determine the severity,local complications and mortality.Generally,BISAP is simple and easy to practice,and better than the other three.
ABSTRACT
BACKGROUND: The nomination of undifferentiated spondyloarthropathy (USpA) has provided clues for the early diagnosis of spondylitis ankylopoietica and other subsets of SpA, thereby avoiding possible wrong treatments.OBJECTIVE: To investigate the prevalence of SpA in the workers and their adult relatives aged over 16 years old from a factory in Beijing urban district, as well as the results of human major histocompatibility complex (MHC) B27 and X-ray inspection on sacroiliac joint.DESIGN: Systematic sampling investigation.SETTING: Department of Internal Medicine, Chenghai District People's Hospital of Shantou City; Rheumatism Research Institute, Medical College of Shantou University; Department of Internal Medicine, Beijing Chaoyang Hospital.PARTICIPANTS: A survey was conducted among 1982 workers and their adult relatives aged over 16 years from a factory in Beijing urban district between May and October 1999; there were 1,025 males and 957 females.They all volunteered into this study after informed of the experiment.METHODS: All examinees were surveyed door to door with the modified Chinese-International Anti-rheumatic Alliance Rheumatism Questionnaire,those with positive results were subjected to physical examination and those suspicious cases were subjected to MHC-B27 and X-ray examination.MAIN OUTCOME MEASURES: The prevalence of SpA in the workersand their adult relatives aged over 16 years from a factory in Beijing urban district, as well as the results of MHC-B27 and sacroiliac joint X-ray inspection.RESULTS: Totally 1,982 subjects were enrolled in this study and all entered the result analysis. The prevalence of spondyloarthropathy was 1.61%(32/1 982), amongst which the prevalence of ankylopoietic spondylitis,USpA, and psoriastic arthritis was 0.31% (6/1 982), 1.21% (24/1 982),and 0.10% (2/1 982), respectively. No other subsets of SpA were observed. USpA was mainly presented by inflammatory lumbago and asymmetric arthrosteitis [83% (20/24), 62% (15/24)], while rheumatoid factor was negative in all subjects. Meanwhile, MHC-B27 was proved positive in 25% (6/24) subjects with the male-to-female ratio of 1.2:1.CONCLUSION: The prevalence of SpA is 1.61% in Beijing urban area,and SpA mainly consists of ankylopoietic spondylitis and USpA.