Open AccessValidation of the efficacy of the prognostic factor score in the Japanese severity criteria for severe acute pancreatitis: A large multicenter study
Author(s) -
Ikeura Tsukasa,
Horibe Masayasu,
Sanui Masamitsu,
Sasaki Mitsuhito,
Kuwagata Yasuyuki,
Nishi Kenichiro,
Kariya Shuji,
Sawano Hirotaka,
Goto Takashi,
Hamada Tsuyoshi,
Oda Takuya,
Yasuda Hideto,
Ogura Yuki,
Miyazaki Dai,
Hirose Kaoru,
Kitamura Katsuya,
Chiba Nobutaka,
Ozaki Tetsu,
Yamashita Takahiro,
Koinuma Toshitaka,
Oshima Taku,
Yamamoto Tomonori,
Hirota Morihisa,
Yamamoto Satoshi,
Oe Kyoji,
Ito Tetsuya,
Iwasaki Eisuke,
Kanai Takanori,
Okazaki Kazuichi,
Mayumi Toshihiko
Publication year - 2017
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640616670566
Subject(s) - medicine , acute pancreatitis , receiver operating characteristic , confidence interval , apache ii , mechanical ventilation , area under the curve , risk factor , retrospective cohort study , severity of illness , pancreatitis , gastroenterology , intensive care unit
Background The Japanese severity criteria for acute pancreatitis (AP), which consist of a prognostic factor score and contrast‐enhanced computed tomography grade, have been widely used in Japan. Objective This large multicenter retrospective study was conducted to validate the predictive value of the prognostic factor score for mortality and complications in severe AP patients in comparison to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Methods Data of 1159 patients diagnosed with severe AP according to the Japanese severity criteria for AP were retrospectively collected in 44 institutions. Results The area under the curve (AUC) for the receiver‐operating characteristic curve of the prognostic factor score for predicting mortality was 0.78 (95% confidence interval (CI), 0.74–0.82), whereas the AUC for the APACHE II score was 0.80 (95% CI, 0.76–0.83), respectively. There were no significant differences in the AUC for predicting mortality between two scoring systems. The AUCs of the prognostic factor scores for predicting the need for mechanical ventilation, the development of pancreatic infection, and severe AP according to the revised Atlanta classification were 0.84 (95% CI, 0.81–0.86), 0.73 (95% CI, 0.69–0.77), and 0.83 (95% CI, 0.81–0.86), respectively, which were significantly greater than the AUCs for the APACHE II score; 0.81 (95% CI, 0.78–0.83) for the need for mechanical ventilation ( p = 0.03), 0.68 (95% CI, 0.63–0.72) for the development of pancreatic infection ( p = 0.02), and 0.80 (95% CI, 0.77–0.82) for severe AP according to the revised Atlanta classification ( p = 0.01). Conclusion The prognostic factor score has an equivalent ability for predicting mortality compared with the APACHE II score. Regarding the ability for predicting the development of severe complications during the clinical course of AP, the prognostic factor score may be superior to the APACHE II score.