Evaluation on APACHEⅡ Score for Deep Fungal Infection in Patients with Severe Acute Pancreatitis at Admission_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DUAN Qunhuan , TANG Zhaohui , QING Baihua

Department of General Surgery, Cenrtal Hospital of Yongzhou, Yongzhou 425006, Hunan Province, China;

Corresponding author：

Keywords：

Pancreatitis; Fungal infection; Acute physiology and chronic health evaluation Ⅱ; Receiver operating characteristic curve; Prediction

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To evaluate the predicted value of APACHEⅡ score at admission for deep fungal infection（DFI） in patients with severe acute pancreatitis （SAP）.
Methods 　The clinical data of 132 patients with SAP from January 2006 to June 2011 in our hospital were analyzed retrospectively. The receiver operating characteristic curve （ROC） was used for evaluating the predicted value.
Results 　Thirty-nine patients with SAP infected DFI （29.5%）,of which 36 patients （92.3%） infected with Candida albicans,2 patients （5.1%） with Candida tropicalis,1 patient （2.6%） with pearl bacteria.And,among these 39 patients,27 patients （69.2%） infected at single site,12 patients （30.8%） infected at multi-site. The APACHEⅡ score in 39 patients with DFI was higher than that of 93 patients without DFI （17.1±3.8 versus 9.7±2.1, t=14.316,P=0.000）.The ROC for APACHEⅡ score predicting DFI was 0.745（P=0.000）, 95%CI was 0.641－0.849.When the cut off point was 15,it showed the best forecast performance,with specificity 0.81, sensitivity 0.72,Youden index 0.53.
Conclusions 　The APACHEⅡ score at admission can preferably predict DFI in patients with SAP； when the APACHEⅡ score is greater than 15,it prompts highly possible of DFI,so preventive anti-fungal treatment may be necessary.

Citation： DUAN Qunhuan,TANG Zhaohui,QING Baihua,.. Evaluation on APACHEⅡ Score for Deep Fungal Infection in Patients with Severe Acute Pancreatitis at Admission. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(2): 197-199. doi: Copy

1.	Kochhar R, Noor MT, Wig J. Fungal infections in severe acute pancreatitis[J]. J Gastroenterol Hepatol, 2011, 26(6)：952-959.
2.	Kochhar R, Ahammed SK, Chakrabarti A, et al. Prevalence and outcome of fungal infection in patients with severe acute pancreatitis[J]. J Gastroenterol Hepatol, 2009, 24(5)：743-747.
3.	贺军，胡虞乾．急性重症胰腺炎合并真菌感染的相关因素[ J]．检验医学与临床，2009，6(3）：191-192．.
4.	陈尔真，蒋健，袁祖荣，等．重症急性胰腺炎合并深部真菌感染的特点及防治[ J]．中国急救医学，2004，24(5)：318-321．.
5.	中华医学会外科学会胰腺学组．急性胰腺炎的临床诊断及分级标准[ J]．中华外科杂志，1997，35(12)：773-775．.
6.	Knaus WA, Draper EA, Wagner DP, et al. APACHE II：a severity of disease classification system[J]. Crit Care Med, 1985, 13(10)：818-829.
7.	Berzin TM, Rocha FG, Whang EE, et al. Prevalence of primary fungal infections in necrotizing pancreatitis[J]. Pancreatology, 2007, 7(1)：63-66.
8.	潘耀振，孙诚谊．暴发性胰腺炎的治疗体会 (附 18例报道 )[J]．中国普外基础与临床杂志，2011，18(3)：255-258．.
9.	Besselink MG, van Santvoort HC, Renooij W, et al. Intestinal barrier dysfunction in a randomized trial of a specific probiotic composition in acute pancreatitis[J]. Ann Surg, 2009, 250(5)： 712-719.
10.	Zhang J, Yuan C, Hua G, et al. Early gut barrier dysfunction in patients with severe acute pancreatitis：attenuated by continuous blood purification treatment[J]. Int J Artif Organs, 2010, 33(10)：706-715.
11.	Xia XM, Wang FY, Wang ZK, et al. Emodin enhances alveolar epithelial barrier function in rats with experimental acute pancreatitis[J]. World J Gastroenterol, 2010, 16(24)：2994-3001.
12.	Lutgendorff F, Nijmeijer RM, Sandstr.m PA, et al. Probiotics prevent intestinal barrier dysfunction in acute pancreatitis in rats via induction of ileal mucosal glutathione biosynthesis[J]. PLoS One，2009，4(2)：e4512-e4524.
13.	Eggimann P, Jamdar S, Siriwardena AK. Pro/con debate： antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics[J]. Crit Care, 2006, 10(5)：229-232.
14.	Trikudanathan G, Navaneethan U, Vege SS. Intra-abdominal fungal infections complicating acute pancreatitis：a review[J]. Am J Gastroenterol, 2011, 106(7)：1188-1192.
15.	Vege SS, Gardner TB, Chari ST, et al. Outcomes of intraabdominal fungal vs. bacterial infections in severe acute pancreatitis[J]. Am J Gastroenterol, 2009, 104(8)：2065-2070.
16.	Park SH, Goo JM, Jo CH. Receiver operating characteristic (ROC)curve：practical review for radiologists[J]. Korean J Radiol, 2004, 5(1)：11-18.
17.	Akobeng AK. Understanding diagnostic tests 3：Receiver operating characteristic curves[J]. Acta Paediatr, 2007, 96(5)： 644-647.
18.	Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction[J]. Circulation, 2007, 115(7)：928-935.

1. Kochhar R, Noor MT, Wig J. Fungal infections in severe acute pancreatitis[J]. J Gastroenterol Hepatol, 2011, 26(6)：952-959.
2. Kochhar R, Ahammed SK, Chakrabarti A, et al. Prevalence and outcome of fungal infection in patients with severe acute pancreatitis[J]. J Gastroenterol Hepatol, 2009, 24(5)：743-747.
3. 贺军，胡虞乾．急性重症胰腺炎合并真菌感染的相关因素[ J]．检验医学与临床，2009，6(3）：191-192．.
4. 陈尔真，蒋健，袁祖荣，等．重症急性胰腺炎合并深部真菌感染的特点及防治[ J]．中国急救医学，2004，24(5)：318-321．.
5. 中华医学会外科学会胰腺学组．急性胰腺炎的临床诊断及分级标准[ J]．中华外科杂志，1997，35(12)：773-775．.
6. Knaus WA, Draper EA, Wagner DP, et al. APACHE II：a severity of disease classification system[J]. Crit Care Med, 1985, 13(10)：818-829.
7. Berzin TM, Rocha FG, Whang EE, et al. Prevalence of primary fungal infections in necrotizing pancreatitis[J]. Pancreatology, 2007, 7(1)：63-66.
8. 潘耀振，孙诚谊．暴发性胰腺炎的治疗体会 (附 18例报道 )[J]．中国普外基础与临床杂志，2011，18(3)：255-258．.
9. Besselink MG, van Santvoort HC, Renooij W, et al. Intestinal barrier dysfunction in a randomized trial of a specific probiotic composition in acute pancreatitis[J]. Ann Surg, 2009, 250(5)： 712-719.
10. Zhang J, Yuan C, Hua G, et al. Early gut barrier dysfunction in patients with severe acute pancreatitis：attenuated by continuous blood purification treatment[J]. Int J Artif Organs, 2010, 33(10)：706-715.
11. Xia XM, Wang FY, Wang ZK, et al. Emodin enhances alveolar epithelial barrier function in rats with experimental acute pancreatitis[J]. World J Gastroenterol, 2010, 16(24)：2994-3001.
12. Lutgendorff F, Nijmeijer RM, Sandstr.m PA, et al. Probiotics prevent intestinal barrier dysfunction in acute pancreatitis in rats via induction of ileal mucosal glutathione biosynthesis[J]. PLoS One，2009，4(2)：e4512-e4524.
13. Eggimann P, Jamdar S, Siriwardena AK. Pro/con debate： antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics[J]. Crit Care, 2006, 10(5)：229-232.
14. Trikudanathan G, Navaneethan U, Vege SS. Intra-abdominal fungal infections complicating acute pancreatitis：a review[J]. Am J Gastroenterol, 2011, 106(7)：1188-1192.
15. Vege SS, Gardner TB, Chari ST, et al. Outcomes of intraabdominal fungal vs. bacterial infections in severe acute pancreatitis[J]. Am J Gastroenterol, 2009, 104(8)：2065-2070.
16. Park SH, Goo JM, Jo CH. Receiver operating characteristic (ROC)curve：practical review for radiologists[J]. Korean J Radiol, 2004, 5(1)：11-18.
17. Akobeng AK. Understanding diagnostic tests 3：Receiver operating characteristic curves[J]. Acta Paediatr, 2007, 96(5)： 644-647.
18. Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction[J]. Circulation, 2007, 115(7)：928-935.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation on APACHEⅡ Score for Deep Fungal Infection in Patients with Severe Acute Pancreatitis at Admission

Abstract Full text Figures/Tables Video References Cited by

Format

Content