Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis

Abstract

Acute severe pancreatitis caused high mortality, and several scoring systems for predicting mortality are available. We evaluated the effectiveness of serial measurement of several scoring systems in patients with acute severe pancreatitis.We retrospectively obtained serial measurements of Ranson, Acute Physiology and Chronic Health Assessment (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scores of 159 patients with acute severe pancreatitis.The overall mortality rate was 20%, and early mortality (in the first 2 weeks) occurred in 10 (7.4%) patients, while late mortality occurred in 17 (12.6%).All scoring systems were reliable for predicting overall and intensive care unit mortality, while the SOFA score on day 7 presented the largest area under the receiver operator characteristic (ROC) curve (0.858, SE 0.055). Changes in scores over time were evaluated for predicting the progression of organ failure, and the change in SOFA score on hospital day 7 or no interval change in SOFA score was associated with higher mortality rates.APACHE II and SOFA scores are both sensitive for predicting mortality in acute pancreatitis. The serial SOFA scores showed reliable for predicting mortality. Hospital day 7 is a reasonable time for SOFA score reassessment to predict late mortality in acute severe pancreatitis.

Soluble urokinase plasminogen activator receptor associates with higher risk, advanced disease severity as well as inflammation, and might serve as a prognostic biomarker of severe acute pancreatitis

“…Acute pancreatitis (AP), one of the most common gastrointestinal diseases, is a rapidly developing inflammatory process of the pancreas, which can cause local injury, systemic inflammatory response syndrome (SIRS), and organ failure . The global incidence of AP ranges from 5 to 30 cases per 100 000 individuals per year and is still increasing in recent years . Although the majority of AP cases are mild and with acceptable prognosis, approximately 20% of AP patients develop moderate‐to‐severe AP (MSAP) and even severe AP (SAP), who present with severe local or systemic complications and poor prognosis .…”

“…1 The global incidence of AP ranges from 5 to 30 cases per 100 000 individuals per year and is still increasing in recent years. 2 Although the majority of AP cases are mild and with acceptable prognosis, approximately 20% of AP patients develop moderate-to-severe AP (MSAP) and even severe AP (SAP), who present with severe local or systemic complications and poor prognosis. 3,4 Therefore, it is of significant importance to explore novel biomarkers which can identify SAP risk, monitor disease condition, and predict prognosis, which thereby improve clinical outcomes and optimize therapy effect in SAP patients.…”

Use of qSOFA criteria in prediction of poor prognosis in acute pancreatitis

“…The repetitive SOFA scores were concluded to be more reliable in predicting the mortality. The 7 th day of hospitalization was indicated to be a convenient time in reevaluating the SOFA score while predicting the late mortality in acute serious pancreatitis [20]. Juneja et al evaluated 55 severe AP patients admitted to the intensive care unit in a two-year period and notified that the SOFA score would be able to be used in predicting 30-day mortality.…”

Escala BISAP en pancreatitis aguda. Azogues 2016-2017. Estudio descriptivo.

“…Es importante recalcar que afecciones crónicas previas, están relacionadas con la presencia y la persistencia de la insuficiencia orgánica. Se debe prestar atención especial a los pacientes que desarrollan insuficiencia orgánica y BISAP ≥ 3, ya que esto puede ser una señal importante de insuficiencia orgánica persistente [13] e ingreso a la unidad de cuidados intensivos [21].…”