The diagnostic value of scoring systems in critical acute pancreatitis: a single center retrospective study

Abstract

Objective To investigate the early diagnostic value of traditional scoring systems in critical acute pancreatitis. Methods From Jan 2007 to Jul 2013, consecutive 184 patients with AP who were admitted to the surgical intensive care unit of the Institute of General Surgery, Nanjing Generai Hospital of Najing Militery Region within 72 h from the onset of the disease were studied. Patients were assigned to four groups, including mild, moderate, severe and critical AP according to the determinant based classification and the receiver operating characteristics(ROC) curve was used to predict the presence of critical AP, and Z test and logistic regression was applied to determine the diagnostic value of traditional scoring systems. Results The area under ROC(AUC) of Sofa, BISAP and CTSI score for early diagnosis of critical AP was 0.896, 0.877 and 0.862; the best cut off value was 4.5, 9.5 and 2.5. Moreover, the AUC of APACHEⅡand Ranson score was 0.807 and 0.707, and the best cut off value was 8.5 and 3.5, respectively. Z test showed early diagnosis rate of Sofa, BISAP, CTSI score was significantly higher than that in Ranson score, and the difference between the two groups was statistically significant (P 0.05). Logistic regression showed that high APACHEⅡ, Sofa, BISAP and CTSI score were independent risk factors for the development of critical AP (P<0.05). Conclusions Sofa, CTSI and BISAP score may be clinically important for early diagnosis of critical AP. Key words: Pancreatitis, acute necrotizing; Early diagnosis; Scoring system; Retrospective studies