COMPARATIVE ANALYSIS OF SCALES FOR OPTIMAL DIAGNOSIS OF BILIARY SEPSIS IN PATIENTS WITH ACUTE CHOLANGITIS

The article gives a retrospective clinical study of 82 patients being treated at the clinic of faculty surgery named after S.P. Fedorov of the Military Medical Academy named after S.M. Kirov with the diagnosis "Acute cholangitis." Patients were divided into "no sepsis" (n = 42) and "with sepsis" (n = 40) groups. The following data were analyzed: clinical, surgical. In the postoperative period, early diagnosis of sepsis development was carried out in patients diagnosed with Acute cholangitis. The diagnosis was based on complaints, objective examination and laboratory and instrumental methods. Patients were assessed with diagnostic scales such as SOFIA, APACHE II, APACHE III, SAPS2, SAPS3.В the following analysis of their accuracy, sensitivity, specificity of prognostic positive and negative capacity, and statistical method of ratio OSH and Criterion Chi-square was used. The SOFIA scale in this study is the "gold standard" in the diagnosis of sepsis in patients with acute cholangitis. This is related to the least number of indicators among other scales, and the SOFIA scale does not require additional examination of the patient by another specialist. The APACHE III and SAPS3 scale requires a license agreement as opposed to a SOFIA scale. However, in our study, the use of the APACHE II scale showed the highest specificity (85.71%) and prognosticality of the negative result. The SAPS2 scale showed the greatest sensitivity (95.00%) and prognostics of the positive result. The most accurate scale is APACHE III, its accuracy is 73.17%. The lowest accuracy and sensitivity is SAPS3 (Se = 55.00%), (Ac = 64.63%).

biliary sepsis, acute cholangitis, assistance with cholangitis timely diagnosis, prevention of complications of cholangitis