Volume 2 Supplement 1

18th International Symposium on Intensive Care and Emergency Medicine

Open Access

Score systems and cardiovascular function in a series of consecutive patients with acute severe acute pancreatitis

  • MV de la Torre1,
  • A García-Alcántara1,
  • A Poullet1,
  • R Toro1,
  • MA Estecha1,
  • A Hernández1 and
  • JL Carpintero1
Critical Care19982(Suppl 1):P152

https://doi.org/10.1186/cc281

Published: 1 March 1998

Introduction

The score systems in Severe Acute Pancreatitis (SAP) are based on the clinical and/or analytical variables and are useful in the Emergency Area Triage (EAT).

Objective

To compare general prediction model, disease-specific score systems and cardiovascular function situation through the pressure-adjusted heart rate (PAR) with mortality.

Method

Prospective study of clinical and laboratory testing in 93 SAP patients treated in the Intensive Care Unit over five years, from 1991–95. On apply APACHE II and Ranson Score at 24 and 48 h. Cardiovascular function at 24, 48 h and first week through PAR, calculated as the product of the heart rate (HR) multiplied by the ratio of the right atrial (central venous) pressure (RAP) to the mean arterial pressure (MAP); PAR=HR×RAP/mean BP [1].

Results

Average age of the 93 cases was 63.9± 13.9 years (26–88), 45.2% being women. Etiology was biliary in 53.5%, alcoholic in 12.8%, pharmacological in 2.8% and idiopathic in 31.4%.

Conclusions

In our SAP patients series 24 h APACHE II score has more prognostic value than Ranson score in mortality. Cardiovascular function at 48 h, pressure-adjusted heart rate (PAR), predict clinical outcomes; it is important to prevent the ocurrence of potentially-life threatening events if there is hemodynamically unstable with a PAR >8. Patients died when a PAR was >14.8 during first week.

Table

 

Mortality

 
 

No

Yes

 

Variable

n

Media

SD

n

Media

SD

P *

24 h APACHE

66

8.9

3.9

26

13.1

6.8

0.000

48 h APACHE

60

9.2

4.8

20

14.9

8.4

0.000

24 h RANSON

66

2.7

1

26

2.8

1.1

ns

48 h Ranson

66

1.8

1.2

23

2.7

1.4

0.004

24 h PAR

53

5.6

3.3

11

6.1

4.9

ns

48 h PAR

52

7.6

4.8

17

20.7

10.5

0.005

1 week PAR

8

7.3

3.5

6

14.8

7.5

ns

*t Test.

Authors’ Affiliations

(1)
Servicio de Medicina Intensica, Hospital Universitario V. de la Victoria

References

  1. Marshall JC, et al: Multiple Organ Dysfunction Score: a reliable description of a complex clinical outcome. Crit Care Med. 1995, 23: 1638-10.1097/00003246-199510000-00007.PubMedView ArticleGoogle Scholar

Copyright

© Current Science Ltd 1998

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