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The Modified Pancreatitis Activity Scoring System Shows Distinct Trajectories in Acute Pancreatitis: An International Study
- Source :
- CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante, instname, Clin Gastroenterol Hepatol
- Publication Year :
- 2022
- Publisher :
- W. B. Saunders Co., Ltd., 2022.
-
Abstract
- BACKGROUND & AIMS: The aims of this study were to: (1) assess the performance of the Pancreatitis Activity Scoring System (PASS) in a large intercontinental cohort of patients with acute pancreatitis (AP); and (2) investigate whether a modified PASS (mPASS) yields a similar predictive accuracy and produces distinct early trajectories between severity subgroups. METHODS: Data was prospectively collected through the Acute Pancreatitis Patient Registry to Examine Novel Therapies In Clinical Experience (APPRENTICE) consortium (2015-2018) involving 22 centers from 4 continents. AP severity was categorized per the revised Atlanta classification. PASS trajectories were compared between the three severity groups using the generalized estimating equations model. Four mPASS models were generated by modifying the morphine equivalent dose (MED), and their trajectories were compared. RESULTS: A total of 1393 subjects were enrolled (median age, 49 years; 51% males). The study cohort included 950 mild (68.2%), 315 (22.6%) moderately severe, and 128 (9.2%) severe AP. Mild cases had the lowest PASS at each study time point (all P < .001). A subset of patients with outlier admission PASS values was identified. In the outlier group, 70% of the PASS variation was attributed to the MED, and 66% of these patients were from the United States centers. Among the 4 modified models, the mPASS-1 (excluding MED from PASS) demonstrated high performance in predicting severe AP with an area under the receiver operating characteristic curve of 0.88 (vs area under the receiver operating characteristic of 0.83 in conventional PASS) and produced distinct trajectories with distinct slopes between severity subgroups (all P < .001). CONCLUSION: We propose a modified model by removing the MED component, which is easier to calculate, predicts accurately severe AP, and maintains significantly distinct early trajectories.
- Subjects :
- Male
medicine.medical_specialty
Severity of Illness Index
Article
Gee
Severity
Cohort Studies
Acute Pancreatitis
Interquartile range
Internal medicine
medicine
Humans
Disease Activity
Generalized estimating equation
Hepatology
business.industry
Gastroenterology
Middle Aged
medicine.disease
PASS
Confidence interval
Systemic inflammatory response syndrome
Pancreatitis
ROC Curve
Acute Disease
Cohort
Acute pancreatitis
Female
business
Subjects
Details
- ISSN :
- 15427714
- Database :
- OpenAIRE
- Journal :
- CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante, instname, Clin Gastroenterol Hepatol
- Accession number :
- edsair.doi.dedup.....ffe8cb7fc76e368281e3ad799a53e039