From the Departement d'Hepato-Gastroenterologie et Nutrition.
Service de Pédiatrie.
Pancreas. 2022 Feb 1;51(2):128-134. doi: 10.1097/MPA.0000000000001984.
The identification of patients at risk of developing a severe form of acute pancreatitis is a major issue. The goal of this study was to identify parameters at admission associated with severe pancreatitis to develop a predictive severity score.
We conducted a retrospective study at Caen University Hospital between January 2014 and December 2017, including 504 patients hospitalized for acute pancreatitis, of whom 74 had a severe form. We developed a predictive score named Admission Severe Acute Pancreatitis (ASAP) score based on parameters associated with a severe form in multivariate analysis. We validated our score in an independent validation cohort of 80 patients.
Hypothermia, low oxygen saturation or albumin levels, and high creatinine levels were significantly associated with severe pancreatitis. The ASAP score showed notable predictive accuracy (area under receiver operating characteristic, 0.82), which was significantly higher than Sequential Organ Failure Assessment, persistent Systemic Inflammatory Response Syndrome, and Balthazar. Using the -2.1742 threshold, the ASAP score had a sensitivity and specificity of 74% and a negative predictive value of 95%. These predictive performances for ASAP score were confirmed in the validation cohort.
The ASAP score demonstrates remarkable predictive accuracy in distinguishing severe forms of acute pancreatitis.
识别发生重症急性胰腺炎风险的患者是一个重要问题。本研究旨在确定入院时与重症胰腺炎相关的参数，以制定预测严重程度的评分。
我们在卡昂大学医院进行了一项回顾性研究，纳入了 2014 年 1 月至 2017 年 12 月期间因急性胰腺炎住院的 504 例患者，其中 74 例为重症。我们基于多变量分析中与重症相关的参数，制定了一种名为入院重症急性胰腺炎（ASAP）评分的预测评分。我们在 80 例独立验证队列中验证了我们的评分。
低体温、低氧饱和度或白蛋白水平以及高肌酐水平与重症胰腺炎显著相关。ASAP 评分具有显著的预测准确性（接受者操作特征曲线下面积，0.82），明显高于序贯器官衰竭评估、持续性全身炎症反应综合征和 Balthazar 评分。使用-2.1742 阈值，ASAP 评分的敏感性和特异性分别为 74%和 95%。这些 ASAP 评分的预测性能在验证队列中得到了证实。
ASAP 评分在鉴别重症急性胰腺炎方面具有显著的预测准确性。
