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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 11
Nov.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(11): 2551-2557

Value of different scoring systems in predicting the severity and prognosis of hyperlipidemic acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2022.11.022

  • Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, China

Research funding:

Hospital Clinical Research Project of The Second Affiliated Hospital of Kunming Medical University (2020ynlc013)

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  • Corresponding author: YANG Jing, yangjing_dl@163.com(ORCID: 0000-0003-3305-8893)
  • Received Date: 2022-04-19
  • Accepted Date: 2022-05-27
  • Published Date: 2022-11-20
    Abstract
  •   Objective  To investigate the best scoring systems for predicting the severity and prognosis of hyperlipidemic acute pancreatitis (HLAP) by comparing APACHEII, BISAP, MCTSI, MEWS, POP, SPS, and PANC3 scores.  Methods  A retrospective analysis was performed for the data of 123 patients with HLAP who were hospitalized and treated in The Second Affiliated Hospital of Kunming Medical University from October 2017 to January 2022. The patients were divided into mild acute pancreatitis (MAP) group with 24 patients, moderate- severe acute pancreatitis (MSAP) group with 56 patients, and severe acute pancreatitis (SAP) group with 43 patients, and the three groups were compared in terms of basic data and scores of the above scoring systems. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between groups. MedCalc software was used to plot the receiver operating characteristic (ROC) curve, and the area under the ROC curve (AUC) was used to compare the value of these scoring systems in predicting disease severity and local and systemic complications in HLAP patients.  Results  There were significant differences between the three groups in diabetes mellitus (χ2=6.880, P < 0.05), length of hospital stay (H=26.494, P < 0.001), local complications (χ2=52.211, P < 0.001), acute kidney injury (AKI) (χ2=38.247, P < 0.001), acute respiratory distress syndrome (ARDS) (χ2=79.201, P < 0.001), and multiple organ dysfunction syndrome (MODS) (χ2=45.032, P < 0.001). As for the scores of the above scoring systems, there were significant differences between the three groups in APACHE Ⅱ, BISAP, MCTSI, MEWS, POP, SPS, and PANC3 (H=47.525, 42.662, 53.545, 31.664, 49.233, 48.543, and 9.443, all P < 0.05). APACHE Ⅱ score had a significantly higher value than MEWS score in predicting SAP (Z=2.090, P < 0.05), and the other scores had a similar value, among which POP score had the largest AUC of 0.883. MCTSI score had the highest value in predicting local complications (AUC=0.886), with a sensitivity of 84.7% and a specificity of 74.5% at the cut-off value of 5. APACHE Ⅱ and POP scores had an AUC of 0.911 (95% confidence interval [CI]: 0.835-0.986, P < 0.001) and 0.920 (95%CI: 0.866-0.974, P < 0.001), respectively, in predicting AKI; APACHE Ⅱ score had a higher predictive value than MCTSI and MEWS scores, POP score had a higher predictive value than MCTSI, MEWS, and BISAP scores, and SPS score had a higher predictive value than MCTSI score. APACHE Ⅱ score had an AUC of 0.914 (95%CI: 0.854-0.973, P < 0.001) in predicting ARDS and had a higher predictive value than BISAP and MEWS (Z=2.152 and 3.015, both P < 0.05). APACHE Ⅱ and POP scores had an AUC of 0.969 (95%CI: 0.941-0.996, P < 0.001) and 0.932 (95%CI: 0.880-0.984, P < 0.001), respectively, in predicting MODS, and APACHE Ⅱ score had a higher predictive value than SPS, BISAP, MEWS, and MCTSI.  Conclusion  POP score has the highest value in predicting SAP, with a comparable predictive ability to all the other scoring systems except MEWS. APACHEII and POP scores have a good value in predicting systemic complications and show a high accuracy in predicting AKI and MODS, and APACHEII score is highly accurate in predicting ARDS.

     

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    • References(24)
  • [1]
    YU H, HUANG Y, CHEN L, et al. Assessment of computed tomography-defined muscle and adipose tissue features in relation to length of hospital stay and recurrence of hypertriglyceridemic pancreatitis[J]. Int J Gen Med, 2021, 14: 1709-1717. DOI: 10.2147/IJGM.S311118.
    [2]
    JIN M, BAI X, CHEN X, et al. A 16-year trend of etiology in acute pancreatitis: The increasing proportion of hypertriglyceridemia-associated acute pancreatitis and its adverse effect on prognosis[J]. J Clin Lipidol, 2019, 13(6): 947-953. e1. DOI: 10.1016/j.jacl.2019.09.005.
    [3]
    WANG Y, CAO LK, WEI Y, et al. The value of modified renal rim grade in predicting acute kidney injury following severe acute pancreatitis[J]. J Comput Assist Tomogr, 2018, 42(5): 680-687. DOI: 10.1097/RCT.0000000000000749.
    [4]
    IYER H, ELHENCE A, MITTAL S, et al. Pulmonary complications of acute pancreatitis[J]. Expert Rev Respir Med, 2020, 14(2): 209-217. DOI: 10.1080/17476348.2020.1698951.
    [5]
    AN WH, HE XC, YANG J, et al. Value of early admission scoring systems in predicting the severity and prognosis of acute pancreatitis[J]. J Clin Hepatol, 2020, 36(6): 1342-1346. DOI: 10.3969/j.issn.1001-5256.2020.06.030.

    安文慧, 何旭昶, 杨婧, 等. 入院早期评分系统对急性胰腺炎严重程度及预后的预测价值[J]. 临床肝胆病杂志, 2020, 36(6): 1342-1346. DOI: 10.3969/j.issn.1001-5256.2020.06.030.
    [6]
    Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association; Editorial Board of Chinese Journal of Pancreatology; Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis (Shenyang, 2019)[J]. J Clin Hepatol, 2019, 35(12): 2706-2711. DOI: 10.3969/j.issn.1001-5256.2019.12.013.

    中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编委会, 《中华消化杂志》编委会. 中国急性胰腺炎诊治指南(2019年, 沈阳)[J]. 临床肝胆病杂志, 2019, 35(12): 2706-2711. DOI: 10.3969/j.issn.1001-5256.2019.12.013.
    [7]
    BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. DOI: 10.1136/gutjnl-2012-302779.
    [8]
    SCHEPERS NJ, BAKKER OJ, BESSELINK MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis[J]. Gut, 2019, 68(6): 1044-1051. DOI: 10.1136/gutjnl-2017-314657.
    [9]
    LI X, KE L, DONG J, et al. Significantly different clinical features between hypertriglyceridemia and biliary acute pancreatitis: a retrospective study of 730 patients from a tertiary center[J]. BMC Gastroenterol, 2018, 18(1): 89. DOI: 10.1186/s12876-018-0821-z.
    [10]
    LARVIN M, MCMAHON MJ. APACHE-Ⅱ score for assessment and monitoring of acute pancreatitis[J]. Lancet, 1989, 2(8656): 201-205. DOI: 10.1016/s0140-6736(89)90381-4.
    [11]
    HAGJER S, KUMAR N. Evaluation of the BISAP scoring system in prognostication of acute pancreatitis - A prospective observational study[J]. Int J Surg, 2018, 54(Pt A): 76-81. DOI: 10.1016/j.ijsu.2018.04.026.
    [12]
    YANG L, LIU J, XING Y, et al. Comparison of BISAP, Ranson, MCTSI, and APACHE Ⅱ in predicting severity and prognoses of hyperlipidemic acute pancreatitis in Chinese patients[J]. Gastroenterol Res Pract, 2016, 2016: 1834256. DOI: 10.1155/2016/1834256.
    [13]
    PANDO E, ALBERTI P, MATA R, et al. Early changes in Blood Urea Nitrogen (BUN) can predict mortality in acute pancreatitis: comparative study between BISAP score, APACHE-Ⅱ, and other laboratory markers-a prospective observational study[J]. Can J Gastroenterol Hepatol, 2021, 2021: 6643595. DOI: 10.1155/2021/6643595.
    [14]
    WU Q, WANG J, QIN M, et al. Accuracy of conventional and novel scoring systems in predicting severity and outcomes of acute pancreatitis: a retrospective study[J]. Lipids Health Dis, 2021, 20(1): 41. DOI: 10.1186/s12944-021-01470-4.
    [15]
    ZENG QX, JIANG KL, WU ZH, et al. Pleural effusion is associated with severe renal dysfunction in patients with acute pancreatitis[J]. Med Sci Monit, 2021, 27: e928118. DOI: 10.12659/MSM.928118.
    [16]
    ALBERTI P, PANDO E, MATA R, et al. Evaluation of the modified computed tomography severity index (MCTSI) and computed tomography severity index (CTSI) in predicting severity and clinical outcomes in acute pancreatitis[J]. J Dig Dis, 2021, 22(1): 41-48. DOI: 10.1111/1751-2980.12961.
    [17]
    ÇAKAR İ, KEVEN A, ESERO ǦLU E, et al. Role of extrapancreatic necrosis volume in determining early prognosis in patients with acute pancreatitis[J]. Abdom Radiol (NY), 2020, 45(5): 1507-1516. DOI: 10.1007/s00261-019-02188-9.
    [18]
    BHATNAGAR M, SIROHI N, DUBEY AB. Prediction of hospital outcome in emergency medical admissions using modified early warning score (MEWS): Indian experience[J]. J Family Med Prim Care, 2021, 10(1): 192-198. DOI: 10.4103/jfmpc.jfmpc_1426_20.
    [19]
    AYGUN H, ERAYBAR S. The role of emergency department triage early warning score (TREWS) and modified early warning score (MEWS) to predict in-hospital mortality in COVID-19 patients[J]. Ir J Med Sci, 2022, 191(3): 997-1003. DOI: 10.1007/s11845-021-02696-y.
    [20]
    HARRISON DA, D'AMICO G, SINGER M. The Pancreatitis Outcome Prediction (POP) Score: a new prognostic index for patients with severe acute pancreatitis[J]. Crit Care Med, 2007, 35(7): 1703-1708. DOI: 10.1097/01.CCM.0000269031.13283.C8.
    [21]
    ESCOBAR-ARELLANO R, GURAIEB-BARRAGáN E, MANSANARES-HERNÁNDEZ A, et al. Sensitivity, specificity and reliability of the POP score vs. APACHE Ⅱ score as predictors of severe acute biliary pancreatitis[J]. Cir Cir, 2019, 87(4): 402-409. DOI: 10.24875/CIRU.18000662.
    [22]
    MOUNZER R, LANGMEAD CJ, WU BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis[J]. Gastroenterology, 2012, 142(7): 1476-1482; quiz e15-16. DOI: 10.1053/j.gastro.2012.03.005.
    [23]
    UEDA T, TAKEYAMA Y, YASUDA T, et al. Simple scoring system for the prediction of the prognosis of severe acute pancreatitis[J]. Surgery, 2007, 141(1): 51-58. DOI: 10.1016/j.surg.2006.05.008.
    [24]
    RATHNAKAR SK, VISHNU VH, MUNIYAPPA S, et al. Accuracy and predictability of PANC-3 scoring system over APACHE Ⅱ in acute pancreatitis: a prospective study[J]. J Clin Diagn Res, 2017, 11(2): PC10-PC13. DOI: 10.7860/JCDR/2017/23168.9375.
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