Comparative evaluation of scales to determine severity of acute pancreatitis

Abstract

Based on the method developed by the authors for quantifying the severity of patients with acute pancreatitis, a method for calculating the duration of therapeutic fasting in a particular patient has been created. We studied the medical histories of 500 patients with acute pancreatitis who were in two medical hospitals from 2010 to 2021. They underwent complex therapy of acute pancreatitis. Based on the dependence found using multivariate regression analysis using the universal statistical software package StatSoft Statistica for OC Windows, the authors previously developed and published a method for calculating the severity of a patient's condition with acute pancreatitis in the enzymatic toxemia phase. This method in the process of practical application was significantly improved by the authors and called the IDAP scale (ACUTE PANCREATITIS HAZARD INDEX). The advantages of this method: the calculation of the severity of the patient's condition can be made at any time of interest, the indicators are included in the Medical and Economic standards of the Russian Federation for acute pancreatitis, it is enough to use the standard office program MS Excel, which is available to any practicing physician. When comparing the results of assessing the severity of patients on the IDAP and APACH II scales, no discrepancies of more than 15% were found in 640 measurements in 50 patients, which allowed us to use the IDAP system in our study on a par with the generally accepted APACH II. At the second stage of the study, as a result of the analysis of 86 clinical observations using the technique of multidimensional regression analysis, a relationship was found between the clinical severity of the patient upon admission to the hospital for treatment, the severity at a given time and the required duration of therapeutic fasting (in days). At the second stage of the study, as a result of the analysis of 86 clinical observations using the technique of multidimensional regression analysis, a relationship was found between the clinical severity of the patient upon admission to the hospital for treatment, the severity at a given time and the required duration of therapeutic fasting (in days). When using this method of calculating the duration of fasting, only 7 (8%) patients had an exacerbation of the process after the start of feeding them through the mouth. Thus, taking into account the coefficient of severity of the patient's condition with acute pancreatitis, it is possible to reliably determine the timing of therapeutic fasting in this disease.