Prognostic factors in acute pancreatitis.

TLDR

Prognostic factor scoring systems predict acute pancreatitis severity, alert clinicians to potential severity, enable comparisons across series, and facilitate patient selection for treatment trials. The study prospectively assesses a nine‑factor system available within 48 hours of admission to predict acute pancreatitis severity. The assessment used nine factors available within 48 hours of admission and excluded data used to develop the system. The nine‑factor system correctly predicted severity in 72% of 405 episodes, with 31% of cases having three or more factors being severe and 8% of cases with fewer than three factors being severe; excluding one non‑predictive factor, the eight‑factor system achieved 79% accuracy.

Abstract

Prognostic factor scoring systems provide one method of predicting severity of acute pancreatitis. This paper reports the prospective assessment of a system using nine factors available within 48 hours of admission. This assessment does not include patient data used to compile the system. Of 405 episodes of acute pancreatitis occurring in a seven year period, 72% had severity correctly predicted by the system; 31% of 131 episodes with three or more factors present were severe and 8% of 274 episodes with less than three factors were severe. Assessment of individual factors revealed only one which did not predict severity. A scoring system based on the other eight factors correctly predicted severity in 79% of episodes. Prognostic factor scoring systems (i) alert the clinician to potentially severe disease, (ii) allow comparison of severity within and between patient series and (iii) will allow rational selection of patients for trials of new treatment.