Early warning scores predict outcome in acute pancreatitis |
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Authors: | Giuseppe Garcea MD Benjamin Jackson MBChB Clare J Pattenden MBChB Christopher D Sutton MD Christopher P Neal MBChB Ashley R Dennison MD David P Berry MD |
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Institution: | (1) Department of Hepatobiliary and Pancreatic Surgery, The Leicester General Hospital, Gwendolen Road, LE5 4PW Leicester, England |
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Abstract: | The Early Warning Score (EWS) is a widely used general scoring system to monitor patient progress with a varying score of
0-20 in critically unwell patients. This study evaluated the EWS system compared with other established scoring systems in
patients with acute pancreatitis. EWS scores were compared with APACHE scores, Imrie scores, computed tomography grading scores,
and Ranson criteria for 110 admissions with acute pancreatitis. A favorable outcome was considered to be survival without
intensive therapy unit admission or surgery. Nonsurvivors, necrosectomy, and critical care admission were considered adverse
outcomes. EWS was the best predictor of adverse outcome in the first 24 hours of admission (receiver operating curve, 0.768).
The most accurate predictor of mortality overall was EWS on day 3 of admission (receiver operating curve, 0.920). EWS correlated
with duration of intensive therapy unit stay and number of ventilated days (P<0.05) and selected those who went on to develop pancreas-specific complications such as pseudocyst or ascites. EWS of 3 or
above is an indicator of adverse outcome in patients with acute pancreatitis. EWS can accurately and reliably select both
patients with severe acute pancreatitis and those at risk of local complications. |
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Keywords: | Acute pancreatitis early warning scores prognosis |
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