Clinical application of TISS-28 in patients with acute pancreatitis in a surgical intensive care unit

  Background  Patients with acute pancreatitis have complicated conditions and long treatment periods, and some patients are admitted to the intensive care unit (ICU) only for monitoring. If the early assessment of disease severity and prognosis can be improved, it will promote the rational use of medical resources for patients with pancreatitis in ICU.

  Objective   To investigate the clinical application of the treatment intervention score system (TISS-28) in ICU patients with acute pancreatitis.

  Methods  From 2015 to 2019, clinical data about patients with acute pancreatitis who were admitted to our hospital were retrospectively analyzed. Patients were divided into the intensive care group and non-intensive care group based on the TISS-28 scoring system. The length of hospital stays, ICU days, respiratory support, renal function support, circulatory support, and prognosis were compared between the two groups, and the survival and death of patients in the intensive care group were also compared.

  Results  A total of 360 patients with acute pancreatitis were enrolled. There were 134 patients in the intensive care group, including 97 males (72.4%), with an average age of (47.8 ± 15.6) years. There were 226 patients in the non-intensive care group, including 160 males (70.8%), with an average age of (45.8 ± 14.1) years. Compared with the non-intensive care group, all patients in the intensive care group had severe acute pancreatitis (SAP), with significantly higher average age (47.8 ± 15.6 yrs vs 44.5 ± 13.0 yrs, P=0.004), higher BMI (24.622.0-27.7 kg/m² vs 23.421.0-26.0 kg/m², P=0.018), shorter hospitalization time from onset to admission (243-47 d vs 4520-74 d, P＜0.001), more extended hospital stays (3018-62 d vs 2415-41 d, P=0.006) and ICU days (103-23 d vs 20-5 d, P＜0.001). Forty-three patients died during hospitalization, with the mortality rate of 11.9% (43/360), all the dead cases were in the intensive care group. The TISS-28 scores of the dead patients on the day of admission and perioperative period were significantly higher than those of the survival patients (2419-40 vs 1814-26, 4737-53 vs 2218-26, P＜0.01, respectively).

  Conclusion  For SAP patients in surgical ICU, TISS-28 score has a particular reference value for evaluating the condition. According to the TISS-28 scoring items, graded treatment can be carried out. Intensive care patients can depend on ICU support, while non-intensive care patients should avoid the occupation of ICU resources.