Early warning score independently predicts adverse outcome and mortality in
patients with acute pancreatitis
#MMPMID28434059
Jones MJ
; Neal CP
; Ngu WS
; Dennison AR
; Garcea G
Langenbecks Arch Surg
2017[Aug]; 402
(5
): 811-819
PMID28434059
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PURPOSE: The aim of this study was to compare the prognostic value of established
scoring systems with early warning scores in a large cohort of patients with
acute pancreatitis. METHODS: In patients presenting with acute pancreatitis, age,
sex, American Society of Anaesthesiologists (ASA) grade, Modified Glasgow Score,
Ranson criteria, APACHE II scores and early warning score (EWS) were recorded for
the first 72 h following admission. These variables were compared between
survivors and non-survivors, between patients with mild/moderate and severe
pancreatitis (based on the 2012 Atlanta Classification) and between patients with
a favourable or adverse outcome. RESULTS: A total of 629 patients were
identified. EWS was the best predictor of adverse outcome amongst all of the
assessed variables (area under curve (AUC) values 0.81, 0.84 and 0.83 for days 1,
2 and 3, respectively) and was the most accurate predictor of mortality on both
days 2 and 3 (AUC values of 0.88 and 0.89, respectively). Multivariable analysis
revealed that an EWS ?2 was independently associated with severity of
pancreatitis, adverse outcome and mortality. CONCLUSION: This study confirms the
usefulness of EWS in predicting the outcome of acute pancreatitis. It should
become the mainstay of risk stratification in patients with acute pancreatitis.
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