HEMOSTASIOLOGICAL MARKERS PREDICTING THE SEVERITY OF ACUTE PANCREATITIS
DOI:
https://doi.org/10.31379/2411.2616.14.2.6Keywords:
acute pancreatitis, hemostasis disorders, thromboelastogram.Abstract
The aim of the study was to identify a prognostically significant hemostasis marker for determining the severity of acute pancreatitis. Materials and methods. The analysis of results of treatment of 482 patients with acute pancreatitis was carried out. The average score of the severity of patients on the APACHE II scale was 9 points, according to the Ranson system, 5 points. In the treatment of acute pancreatitis, minimally invasive technologies were used as the main and final method. Hemostasiological parameters were analyzed: activated partial thromboplastin time, prothrombin time, the number of platelets and fibrinogen, the level of antithrombin and soluble fibrin-monomer complexes, aggregation activity of thrombocytes. Thromboelastography was used as an integral method for assessing the functional state of the hemostatic system. The prognostic significance of the identified patterns was evaluated on the basis of ROC analysis. Results. According to the results of multivariate regression analysis, among the qualitative parameters, the most prognostically significant factor in the development of severe pancreatitis is the MA thromboelastogram score (b = 0.652, p <0.033). In the formation of a normal clot according to the TEG data, at the early stage of the pathological process, severe pancreatitis developed in 7.7% of patients, with a pathologically dense clot recorded in 22.2% of patients, and in the presence of a pathologically loose clot in 65.5% of patients. An early predictor of the development of severe pancreatitis was the presence of a pathologically loose clot from the data of thromboelastogram. The ROC analysis showed good predictive value of the revealed regularity (AUROC = 0.808, 95% confidence interval – 0.686- 0.898, P= < 0,0001). Сonclusion. Hemostasiological marker for the prediction of severe degree of acute pancreatitis – the presence of a patient with a pathologically loose clot from entering a thromboelastogram.
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