The Modified Pancreatitis Activity Scoring System Shows Distinct Trajectories in Acute Pancreatitis: An International Study.
The Modified Pancreatitis Activity Scoring System Shows Distinct Trajectories in Acute Pancreatitis: An International Study.
- 2021
BACKGROUND AND AIMS: The aims of this study were to: 1) assess the performance of the pancreatitis activity scoring system (PASS) in a large intercontinental AP cohort, 2) investigate whether a modified PASS, yields a similar predictive accuracy and produces distinct early trajectories between severity subgroups. 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. Copyright (c) 2021 AGA Institute. Published by Elsevier Inc. All rights reserved. METHODS: Data was prospectively collected through the APPRENTICE consortium (2015-2018) involving 22 centers from four continents. AP severity was categorized per Revised Atlanta Classification. PASS trajectories were compared between the three severity groups using the Generalized Estimating Equations model. Four modified PASS (mPASS) models were generated by modifying the Morphine Equivalent Dose (MED), and their trajectories were compared. RESULTS: A total of 1,393 subjects were enrolled (median age of 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 Ps <0.001). 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 US centers. Among the four modified models, the mPASS-1 (excluding MED from PASS) demonstrated high performance in predicting severe AP with an AUC of 0.88 (vs. AUC of 0.83 in conventional PASS) and produced distinct trajectories with distinct slopes between severity subgroups (all Ps <0.001).
English
1542-3565
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Internal Medicine Residency
Journal Article
BACKGROUND AND AIMS: The aims of this study were to: 1) assess the performance of the pancreatitis activity scoring system (PASS) in a large intercontinental AP cohort, 2) investigate whether a modified PASS, yields a similar predictive accuracy and produces distinct early trajectories between severity subgroups. 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. Copyright (c) 2021 AGA Institute. Published by Elsevier Inc. All rights reserved. METHODS: Data was prospectively collected through the APPRENTICE consortium (2015-2018) involving 22 centers from four continents. AP severity was categorized per Revised Atlanta Classification. PASS trajectories were compared between the three severity groups using the Generalized Estimating Equations model. Four modified PASS (mPASS) models were generated by modifying the Morphine Equivalent Dose (MED), and their trajectories were compared. RESULTS: A total of 1,393 subjects were enrolled (median age of 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 Ps <0.001). 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 US centers. Among the four modified models, the mPASS-1 (excluding MED from PASS) demonstrated high performance in predicting severe AP with an AUC of 0.88 (vs. AUC of 0.83 in conventional PASS) and produced distinct trajectories with distinct slopes between severity subgroups (all Ps <0.001).
English
1542-3565
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Internal Medicine Residency
Journal Article