Evaluation of CT severity index, Ranson and APACHE II and Ranson scores for clinical course and mortality in mechanically ventilated patients depend to severe pancreatitis

Abstract

Objective:To evaluate the utility of CT severity index (CTSI) and two main scoring systems (Ranson and APACHE II) for patients underwent mechanical ventilation due to pulmonary complications associated with severe pancreatitis. Materials and Methods:Mechanical ventilated patients due to severe acute pancreatitis were enrolled the study. CTSI and two traditional clinical scoring systems including APACHE II and Ranson were used to predict the mortality rates in mechanical ventilated patients due to severe AP. Results:Nine of 36 patients were survived (25%). The ICU (Intensive Care Unit) mortality was 66.6% (n= 24) and hospital mortality was 75% (n=27). Patients had upper then 17 scores for APACHE II score, the sensitivity and specificity were 64% and 66%, respectively to predict the mortality, by CTSI (>4) and Ranson scoring system (>6) with sensitivity and specificity of 60% and 40% and 50% and 46%, respectively. Conclusion:In this study, high scores of CTSI, Ranson and APACHE II were found to be independent predictors in patients underwent mechanical ventilated due to severe pancreatitis in ICU. However, APACHE II was the most reliable and effective scoring system for predicting the mortality rate.Key Words: Acute pancreatitis, APACHE II, CT severity index, Ranson scoring system ÖZET Amaç:Şiddetli akut pankreatitte, pulmoner komplikasyonlar sıklıkla görülmektedir. Bu çalışmada, akut pankreatite bağlı gelişen pulmoner komplikasyonlar nedeniyle mekanik ventilasyon uygulanan hastalarda bilgisayarlı tomografi şiddet indeksi (CTSI) ve geleneksel iki farklı skorlama sistemi olan APACHE II ve Ranson skorlama sistemlerinin uygulanabilirliği ve güvenilirliğinin karşılaştırılması amaçlandı. Gereç ve