A simple prognostic score for risk assessment in patients with acute pancreatitis |
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| Authors: | A. Gonzálvez-Gasch G. García de Casasola R. Barba Martín B. Herreros C. Guijarro |
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| Affiliation: | 1. Unidad de Medicina Interna, USP Hospital San Jaime, Partida de la Loma s/n, 03184 Torrevieja, Alicante, Spain;2. Hospital Infanta Cristina, Carretera de Madrid-Toledo (N-401), Km 23.6, 28980, Madrid, Spain;3. Hospital Universitario Fundación Alcorcón, C/ Budapest-1, 28922 Alcorcón, Madrid, Spain;1. Department of Hematology, Hospital Universitario La Fe, Valencia, Spain;2. UOC Trapianto di Cellule Staminali, Università di Roma Tor Vergata, Italy;3. Hospital Clínico Universitario, Valencia, Spain;4. Hospital Reina Sofía, Córdoba, Spain;5. Hospital Universitari Germans Trias I Pujol, Barcelona, Spain;6. Azienda Ospedaliera Universitaria Careggi, Firenze, Italy;7. Hospital Niño Jesús, Madrid, Spain;8. Ospedali Riuniti di Bergamo, Italy;9. Hospital Universitari Vall D’Hebron, Barcelona, Spain;10. Department of Pediatrics, Hospital Universitario La Fe, Valencia, Spain;11. Servicio de Hematologia Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain;12. Department of Pediatrics, Hospital Universitari Vall D’Hebron, Barcelona, Spain;13. Hospital Carlos Haya, Málaga, Spain;14. Hospital La Paz, Madrid, Spain;1. Division of Cardiovascular Surgery, Mayo Clinic;2. Consultant Cardiovascular Surgeon, Adventist Wockhardt Heart Hospital, Surat Gujarat;1. Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain;2. Department of Nuclear Medicine, Clinica Universidad de Navarra, Pamplona, Spain;3. Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain;1. Editora jefe;2. Editores asociados;1. Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, 55455, USA;2. Department of Radiology, University of Minnesota, Minneapolis, MN, 55455, USA;3. Saint Louis University Center for Outcomes Research, St Louis, MO, USA |
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| Abstract: | BackgroundAcute pancreatitis (AP) is a common disease that poses potential serious problems. Its clinical course is often unpredictable. Identification of high risk patients enables early appropriate treatment.MethodsWe conducted a prospective study to develop a new prognostic method that can objectively and easily grade the severity of AP within the first 72 h of admission. The prediction rule was based on clinical and analytical parameters in 308 patients admitted in a community-based hospital. We validated the score in 193 additional patients in the same hospital.ResultsIndependent prognostic factors related to poor prognosis were age > 65 years, leucocytes > 13,000/mm3, albumin < 2.5 mg/dL, calcium < 8.5 mg/dL and reactive C protein > 150 mg/dL. We assigned points to each of the independent factors for complicated AP in proportion to the regression coefficients. We defined three different risk groups according to the points obtained in the prediction rule. Low risk, 0 points (18% patients, 0% risk), moderate, 1–3 points (56% patients, 19% risk) and high, 4–6 points (26% patients, 73% risk). The sensitivity of this formula was 90% with specificity of 63%. The positive and negative predictive values were 50% and 94% respectively.ConclusionsOur simple prediction rule is an additional tool that may help physicians stratifying the severity of AP. Patients with high risk for complicated AP should be kept under close surveillance whereas low risk patients would not need special monitoring. |
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