scholarly journals Haemoconcentration as a predictor of severity in acute pancreatitis

2016 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Tanka Prasad Bohara ◽  
Dimindra Karki ◽  
Anuj Parajuli ◽  
Shail Rupakheti ◽  
Mukund Raj Joshi
Keyword(s):  
Acute Pancreatitis ◽  
Pearson Correlation ◽  
Characteristic Curve ◽  
Scoring Systems ◽  
Cost Effective ◽  
Receiver Operator Characteristic Curve ◽  
First Episode ◽  
P Value ◽  
Receiver Operator Characteristic ◽  
Chi Square

Background: Acute pancreatitis is usually a mild and self-limiting disease. About 25 % of patients have severe episode with mortality up to 30%. Early identification of these patients has potential advantages of aggressive treatment at intensive care unit or transfer to higher centre. Several scoring systems are available to predict severity of acute pancreatitis but are cumbersome, take 24 to 48 hours and are dependent on tests that are not universally available. Haematocrit has been used as a predictor of severity of acute pancreatitis but some have doubted its role.Objectives: To study the significance of haematocrit in prediction of severity of acute pancreatitis.Methods: Patients admitted with first episode of acute pancreatitis from February 2014 to July 2014 were included. Haematocrit at admission and 24 hours of admission were compared with severity of acute pancreatitis. Mean, analysis of variance, chi square, pearson correlation and receiver operator characteristic curve were used for statistical analysis.Results: Thirty one patients were included in the study with 16 (51.61%) male and 15 (48.4%) female. Haematocrit at 24 hours of admission was higher in severe acute pancreatitis (P value 0.003). Both haematocrit at admission and at 24 hours had positive correlation with severity of acute pancreatitis (r: 0.387; P value 0.031 and r: 0.584; P value 0.001) respectively.Area under receiver operator characteristic curve for haematocrit at admission and 24 hours were 0.713 (P value 0.175, 95% CI 0.536 - 0.889) and 0.917 (P value 0.008, 95% CI 0.813 – 1.00) respectively.Conclusion: Haematocrit is a simple, cost effective and widely available test and can predict severity of acute pancreatitis.Journal of Kathmandu Medical College, Vol. 4(1) 2015, 3-7

AVALIAÇÃO DE UM INSTRUMENTO DE MENSURAÇÃO DE MORBIDADE PSÍQUICA: ESTUDO DE VALIDAÇÃO DO SELF-REPORTING QUESTIONNAIRE (SRQ-20)

1970 ◽  
Vol 34 (3) ◽  
pp. 544 ◽  
Author(s):  
Kionna Oliveira Bernardes Santos ◽  
Tânia Maria de Araújo ◽  
Paloma de Sousa Pinho ◽  
Ana Cláudia Conceição Silva
Keyword(s):  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Clinical Interview ◽  
Receiver Operator Characteristic ◽  
Interview Schedule ◽  
Para Determinar ◽  
Self Reporting Questionnaire

O Self-Reporting Questionnaire (SRQ-20), desenvolvido pela Organização Mundial de Saúde, tem sido utilizado para mensuração de nível de suspeição de transtornos mentais em estudos brasileiros, especialmente em grupos de trabalhadores. O objetivo deste estudo foi avaliar o desempenho do SRQ-20, com base em indicadores de validade (sensibilidade, especificidade, taxa de classificação incorreta e valores preditivos), e determinar o melhor ponto de corte para classificação dos transtornos mentais comuns na população estudada. O estudo incluiu 91 indivíduos selecionados aleatoriamente de um estudo de corte transversal realizado com população residente em áreas urbanas de Feira de Santana (BA). Entrevistas clínicas, realizadas por psicólogas, utilizando o Revised Clinical Interview Schedule (CIS-R), foi adotada como padrão-ouro. Na avaliação do desempenho do SRQ-20 foram estimados indicadores de validade (sensibilidade e especificidade). A curva Receiver Operator Characteristic Curve (ROC) foi utilizada para determinar o melhor ponto de corte para classificação de suspeitos/não suspeitos. O ponto de corte de melhor desempenho foi de 6/7 para a população investigada, revelando desempenho razoável com área sob a curva de 0,789. Os resultados indicam que o SRQ-20 possui característica discriminante regular.

scholarly journals Accuracy of conventional and novel scoring systems in predicting severity and outcomes of acute pancreatitis: a retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Qing Wu ◽  
Jie Wang ◽  
Mengbin Qin ◽  
Huiying Yang ◽  
Zhihai Liang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Scoring System ◽  
Characteristic Curve ◽  
Failure Prediction ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Severity Prediction ◽  
Index Of Severity ◽  
Glasgow Score

Abstract Background Recently, several novel scoring systems have been developed to evaluate the severity and outcomes of acute pancreatitis. This study aimed to compare the effectiveness of novel and conventional scoring systems in predicting the severity and outcomes of acute pancreatitis. Methods Patients treated between January 2003 and August 2020 were reviewed. The Ranson score (RS), Glasgow score (GS), bedside index of severity in acute pancreatitis (BISAP), pancreatic activity scoring system (PASS), and Chinese simple scoring system (CSSS) were determined within 48 h after admission. Multivariate logistic regression was used for severity, mortality, and organ failure prediction. Optimum cutoffs were identified using receiver operating characteristic curve analysis. Results A total of 1848 patients were included. The areas under the curve (AUCs) of RS, GS, BISAP, PASS, and CSSS for severity prediction were 0.861, 0.865, 0.829, 0.778, and 0.816, respectively. The corresponding AUCs for mortality prediction were 0.693, 0.736, 0.789, 0.858, and 0.759. The corresponding AUCs for acute respiratory distress syndrome prediction were 0.745, 0.784, 0.834, 0.936, and 0.820. Finally, the corresponding AUCs for acute renal failure prediction were 0.707, 0.734, 0.781, 0.868, and 0.816. Conclusions RS and GS predicted severity better than they predicted mortality and organ failure, while PASS predicted mortality and organ failure better. BISAP and CSSS performed equally well in severity and outcome predictions.

scholarly journals Acute pancreatitis and low ascites-serum albumin gradient ascites caused by Brucellosis

2021 ◽  
Vol 8 (8) ◽  
pp. 470-474
Author(s):  
Mesut Aydin
Keyword(s):  
Acute Pancreatitis ◽  
Serum Proteins ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Chi Square ◽  
Pancreatic Leakage ◽  
Brucella Infection ◽  
The World ◽  
Chi Square Test ◽  
Spss Software

Objective: Brucellosis is a zoonotic disease seen widely around the world. Although many aspects and treatment of this disease is well known, peritoneal involvement and ascites is not well established so far. Material and Methods: This study retrospectively enrolled 346 adult patients (aged >17 years) with acute Brucellosis attending Hepatology Clinic, Van Yuzuncu Yil University, between April 2013 and May 2016. Characteristics of those with and without ascites were analyzed using Pearson correlation coefficients and Chi-Square test in SPSS software system. Results: Of the 346 cases, 20 (5, 7%) had ascites. Those with ascites had significantly higher transaminase, cholestatic enzyme and amylase levels compared to those without ascites. Conclusions: We conclude that acute Brucella infection can lead to a unique low gradient ascites probably resulting from pancreatic leakage followed by peritoneal accumulation of serum proteins.

scholarly journals Nephelometric determination of carbohydrate deficient transferrin

1996 ◽  
Vol 42 (4) ◽  
pp. 551-557 ◽  
Author(s):  
F Schellenberg ◽  
M Martin ◽  
E Cacès ◽  
J Y Bénard ◽  
J Weill
Keyword(s):  
Sialic Acid ◽  
Characteristic Curve ◽  
Anion Exchange Chromatography ◽  
Receiver Operator Characteristic Curve ◽  
Exchange Chromatography ◽  
Treatment Center ◽  
Serum Transferrin ◽  
Receiver Operator Characteristic ◽  
Carbohydrate Deficient Transferrin

Abstract We describe a technique for measuring carbohydrate-deficient transferrin (CDT) in serum. Serum transferrin fractions are separated by anion-exchange chromatography on microcolumns. Sialic acid-deficient transferrin fractions are collected in the eluate, and transferrin is then quantified by a rate-nephelometric technique. Imprecision (CV) was 4-5% within-run and 7-9% between runs (n = 15). Comparison with an isoelectric focusing-immunofixation method for transferrin index (x) yielded y = 761x + 7, Sy/x = 39 mg/L. Assay of sera from 90 abstainers or moderate consumers of alcohol showed that 81 (90%) had CDT concentrations between 30 and 70 mg/L. Among 74 alcoholics admitted to an alcohol treatment center, 54 (73%) had CDT > 70 mg/L, i.e., the diagnostic sensitivity was 73% at a specificity of 90% (area under receiver-operator characteristic curve = 0.891).

Diagnostic and prognostic utility of phospholipase A activity in patients with acute pancreatitis: comparison with amylase and lipase

1991 ◽  
Vol 37 (3) ◽  
pp. 356-360 ◽  
Author(s):  
Steven C Kazmierczak ◽  
Frederick Van Lente ◽  
Edna D Hodges
Keyword(s):  
Acute Pancreatitis ◽  
Diagnostic Accuracy ◽  
Enzyme Activities ◽  
Serum Amylase ◽  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Curve Analysis ◽  
Phospholipase A ◽  
Cutoff Values ◽  
Prognostic Utility

Abstract We compared the diagnostic and prognostic utility of phospholipase A (PLA; EC 3.1.1.4) for acute pancreatitis with that of amylase and lipase by analysis of sera from 151 consecutive patients presenting with abdominal pain in whom assays of serum amylase and (or) lipase had been ordered. We determined the diagnostic accuracy for both the initial and the peak enzyme activities. Maximal diagnostic accuracy obtained for the initial activities of amylase, lipase, and PLA was 0.83, 0.83, and 0.76 at cutoff values of 650, 650, and 41 U/L, respectively. Use of peak enzyme activities showed maximal diagnostic accuracy of 0.85, 0.86, and 0.73 at cutoff values of 650, 1050, and 42 U/L, respectively. Receiver-operator characteristic curve analysis revealed the diagnostic performance of amylase and lipase to be similar, whereas that of PLA was almost random and not incremental. As with amylase and lipase, PLA activities in sera showed no relation to patients' survival; three patients who died after an attack of acute pancreatitis failed to demonstrate the dramatic increases in PLA activity previously described. We conclude that assessing the severity of acute pancreatitis by using enzyme activities still remains problematical. Measurements of amylase or lipase activities provide similar diagnostic discrimination when appropriate cutoff values are used and remain the methods of choice for diagnosis of acute pancreatitis.

scholarly journals A new approach to scoring systems to improve identification of acute medical admissions that will require critical care

2011 ◽  
Vol 56 (4) ◽  
pp. 195-202 ◽  
Author(s):  
H A Carmichael ◽  
E Robertson ◽  
J Austin ◽  
D Mccruden ◽  
C M Messow ◽  
...  
Keyword(s):  
Early Warning ◽  
Characteristic Curve ◽  
Medical Patient ◽  
Scoring Systems ◽  
Receiver Operator Characteristic Curve ◽  
Early Warning Score ◽  
Peripheral Oxygen Saturation ◽  
Logistic Regression Models ◽  
Prospective Application ◽  
Gas Measurements

Removal of the intensive care unit (ICU) at the Vale of Leven Hospital mandated the identification and transfer out of those acute medical admissions with a high risk of requiring ICU. The aim of the study was to develop triaging tools that identified such patients and compare them with other scoring systems. The methodology included a retrospective analysis of physiological and arterial gas measurements from 1976 acute medical admissions produced PREEMPT-1 (PRE-critical Emergency Medical Patient Triage). A simpler one for ambulance use (PREAMBLE-1 [PRE-Admission Medical Blue-Light Emergency]) was produced by the addition of peripheral oxygen saturation to a modification of MEWS (Modified Early Warning Score). Prospective application of these tools produced a larger database of 4447 acute admissions from which logistic regression models produced PREEMPT-2 and PREAMBLE-2, which were then compared with the original systems and seven other early warning scoring systems. Results showed that in patients with arterial gases, the area under the receiver operator characteristic curve was significantly higher in PREEMPT-2 (89·1%) and PREAMBLE-2 (84.4%) than all other scoring systems. Similarly, in all patients, it was higher in PREAMBLE-2 (92.4%) than PREAMBLE-1 (88.1%) and the other scoring systems. In conclusion, risk of requiring ICU can be more accurately predicted using PREEMPT-2 and PREAMBLE-2, as described here, than by other early warning scoring systems developed over recent years.

scholarly journals Identifying High-Risk Children in the Emergency Department

2016 ◽  
Vol 31 (10) ◽  
pp. 660-666 ◽  
Author(s):  
Katie R. Nielsen ◽  
Russ Migita ◽  
Maneesh Batra ◽  
Jane L. Di Gennaro ◽  
Joan S. Roberts ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Characteristic Curve ◽  
Pediatric Intensive Care ◽  
Receiver Operator Characteristic Curve ◽  
Clinical Deterioration ◽  
Chi Square ◽  
Inpatient Ward ◽  
Increased Risk ◽  
Chi Square Analysis

Purpose: Early warning scores (EWS) identify high-risk hospitalized patients prior to clinical deterioration; however, their ability to identify high-risk pediatric patients in the emergency department (ED) has not been adequately evaluated. We sought to determine the association between modified pediatric EWS (MPEWS) in the ED and inpatient ward-to-pediatric intensive care unit (PICU) transfer within 24 hours of admission. Methods: This is a case–control study of 597 pediatric ED patients admitted to the inpatient ward at Seattle Children’s Hospital between July 1, 2010, and December 31, 2011. Cases were children subsequently transferred to the PICU within 24 hours, whereas controls remained hospitalized on the inpatient ward. The association between MPEWS in the ED and ward-to-PICU transfer was determined by chi-square analysis. Results: Fifty children experienced ward-to-PICU transfer within 24 hours of admission. The area under the receiver–operator characteristic curve was 0.691. Children with MPEWS > 7 in the ED were more likely to experience ward-to-PICU transfer (odds ratio 8.36, 95% confidence interval 2.98-22.08); however, the sensitivity was only 18.0% with a specificity of 97.4%. Using MPEWS >7 for direct PICU admission would have led to 167 unnecessary PICU admissions and identified only 9 of 50 patients who required PICU care. Conclusions: Elevated MPEWS in the ED is associated with increased risk of ward-to-PICU transfer within 24 hours of admission; however, an MPEWS threshold of 7 is not sufficient to identify more than a small proportion of ward-admitted children with subsequent clinical deterioration.

scholarly journals RELATIONSHIP between NURSE CHARACTERISTICS WITH DISCHARGE PLANNING IMPLEMENTATION

2017 ◽  
Vol 1 (2) ◽  
pp. 193-197
Author(s):  
Ana Zakiyah ◽  
Duwi Basuki ◽  
Windu Santoso
Keyword(s):  
Discharge Planning ◽  
Pearson Correlation ◽  
Sampling Technique ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Planning Implementation ◽  
Relationship Of ◽  
The Relationship

Discharge planning is one of the activities in the provision of nursing care on patients in the hospital, it will have a shortening impact on patient care in the hospital and reduce the patient's recurrence rate, but the implementation is not appropriate. so far, implementation of Discharge planning is still to be done after the patient finished having treatment by making a summary of the recording of patients return. Various characteristic factors of nurses can influence the implementation of discharge planning in hospital. The research purpose was to know the relationship of factors that influence discharge planning with the implementation of discharge planning. The research design used was cross-sectional, the instrument used was the questionnaire about the characteristics of the nurses and the implementation of discharge planning. The population of research was nurses who served in the inpatient room RSI Sakinah Mojokerto number of 80 nurses and obtained the number of 67 samples with proportional random sampling technique. The result of analysis with pearson correlation for age, education, length of work and chi-square for marital status showed that the characteristics of nurses related to discharge planning implementation were educational factor with p-value 0,023. The higher the nurse education caused more critical, logical and systematic in thinking so as to improve the quality of its work and the greater the desire to utilize the knowledge and skills it possesses keywords        : discharge planning, nurses, education

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