Academic Journal
Acute Pancreatitis in the Emergency Department
| العنوان: | Acute Pancreatitis in the Emergency Department |
|---|---|
| المؤلفون: | Lopez, BS, Gregory J., Hall, MD, Matt, Babineau, MD, Matthew, Kothari, MD, Darshan, Burke, PhD, MPH, Ryan C., Wolfe, MD, Richard E., Sheth, MD, Sunil G., Freedman, MD, Stephen, Shapiro, MD, Nathan I., Tibbles, MD, Carrie |
| المصدر: | Phase 1 |
| بيانات النشر: | Jefferson Digital Commons |
| سنة النشر: | 2019 |
| المجموعة: | Jefferson Digital Commons (Thomas Jefferson University, Philadelphia) |
| مصطلحات موضوعية: | Scholarly Inquiry, JeffMD, acute pancreatitis, emergency department, Harmless Acute Pancreatitis Score, Bedside Index of Severity in Acute Pancreatitis, Glasgow-Imrie criteria, Emergency Medicine, Medicine and Health Sciences |
| الوصف: | Introduction: Acute pancreatitis (AP) is a common emergency department (ED) presentation with a variety of outcomes. Stratifying AP severity with scoring systems can allow physicians to effectively manage patient disposition. Objective: To identify ED pancreatitis patients who will likely be admitted to the ICU or be discharged within 48 hours, and to validate existing pancreatitis severity scores. Methods: Patients with a final ED diagnosis of AP and/or lipase ≥ 3 times the upper limit of normal were enrolled in a prospective, observational chart review study. Parametric and non-parametric descriptive statistics were used to describe the patient population. Area under receiver operating curve (AUC) was used to determine the predictive accuracy of existing pancreatitis scores. Results: Ranson criteria, Glasgow-Imrie (GI) criteria, Bedside Index of Severity in Acute Pancreatitis (BISAP), and Harmless Acute Pancreatitis Score (HAPS) were assessed. GI criteria (AUC = 0.77) had the highest predictive accuracy for ICU admission, while Ranson criteria (AUC = 0.62) had the highest predictive accuracy for early discharge. Mean scores of ICU patients were significantly (p < 0.05) higher than those of non-ICU patients in all four scoring systems; however, mean scores in ICU patients failed to meet the severe case threshold for all four scoring systems. Discussion: Existing pancreatitis scoring systems cannot consistently predict AP severity in ED patients. The small difference in mean ICU and non-ICU patient scores illustrates the difficulty of using scoring systems to stratify AP severity in the ED. Further efforts to develop an ED-specific scoring system could allow physicians to more efficiently admit patients. |
| نوع الوثيقة: | text |
| وصف الملف: | application/pdf |
| اللغة: | English |
| Relation: | https://jdc.jefferson.edu/si_ctr_2021_phase1/24; https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1026&context=si_ctr_2021_phase1 |
| الاتاحة: | https://jdc.jefferson.edu/si_ctr_2021_phase1/24 https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1026&context=si_ctr_2021_phase1 |
| رقم الانضمام: | edsbas.1AF526B0 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |