Medical Science
Volume 25, Issue 111, May, 2021
Predicting early mortality in treatment of patients with acute infectious pancreatitis using two surgical strategies
Kryvoruchko IA1♦, Sykal MO, Yevtushenko OV
Kharkiv National Medical University of the Ministry of Health of Ukraine, Kharkiv, Ukraine
♦Corresponding author
Professor Kryvoruchko I.A., Kharkiv National Medical University,
Ministry of Health of Ukraine,
Ukraine
ABSTRACT
Background: To determine the prediction of mortality and to develop a mathematical model of severe acute pancreatitis designed to predict early mortality in patients with secondary pancreatic infection. Methods: It study was based on data from comparing of severity scores for two surgical strategies in 103 patients who were operated with secondary pancreatic infection and the condition was assessed before surgery and after 48 hours using most significant indicators which are given nowadays the most attention worldwide. Results: According to the goals and objectives of the study all patients were divided into two groups: the main groups were 56 patients with secondary pancreatic infection, which used tactics of treatment step-up approach (after surgery 3 patients (5.3%) were died); the comparison groups were 47 patients with open surgical intervention (after surgery 7 patients (14.9%) were died). The main finding of this study was been that I-FABP, lactate, СRP, SBP and APP not only before surgery is superior in
predicting SPI in comparison to commonly used markers such as APACHE-II, SOFA scores, and serum PCT, IL-6 in 48 hours after ones. It well-known scores have not shown the ability to predict early mortality before surgery: APACHE II scores (AUC 0.558) and SOFA (AUC 0.734). These turned out to be: APP (AUC 0.81) and I-FABP level (AUC 0.881) most suitable for building mathematical prognostic model. Conclusions: The assessment of effective biomarkers has made it possible to personalize surgical tactics and improve outcomes of the treatment.
Keywords: acute infectious pancreatitis, biomarkers, prediction of early
mortality, mathematical model, surgical strategies, results.
Medical Science, 2021, 25(111), 1092-1105
