A simple new scoring system for predicting the mortality of severe acute pancreatitis

Abstract

It is critical to accurately identify patients with severe acute pancreatitis (SAP) in a timely manner. This study aimed to develop a new simplified AP scoring system based on data from Chinese population. We retrospectively analyzed a consecutive series of 585 patients diagnosed with SAP at the Changhai hospital between 2009 and 2017. The new Chinese simple scoring system (CSSS) was derived using logistic regression analysis and was validated in comparison to 4 existing systems using receiver operating characteristic curves. Six variables were selected for incorporation into CSSS, including serum creatinine, blood glucose, lactate dehydrogenase, heart rate, C-reactive protein, and extent of pancreatic necrosis. The new CSSS yields a maximum total score of 9 points. The cut-offs for predicting mortality and severity (discriminating moderately SAP from SAP) were set as 6 points and 4 points respectively. Compared with 4 existing scoring systems, the area under the receiver operating characteristic of CSSS for prediction of mortality was 0.838, similar to acute physiology and chronic health evaluation II (0.844) and higher than Ranson's score (0.702, P < .001), bedside index of severity in acute pancreatitis (0.615), and modified computed tomography severity index (MCTSI) (0.736). For predicting SAP severity, CSSS was the most accurate (0.834), followed by acute physiology and chronic health evaluation II (0.800), Ranson's score (0.702), MCTSI (0.660), and bedside index of severity in acute pancreatitis (0.570). Further, the accuracy of predicting pancreatic infection with CSSS was the highest (0.634), similar to that of MCTSI (0.641). A new prognostic scoring system for SAP was derived and validated in a Chinese sample. This scoring system is a simple and accurate method for prediction of mortality.

Accuracy of conventional and novel scoring systems in predicting severity and outcomes of acute pancreatitis: a retrospective study

“…The cutoff points were 4 for severity and 6 for mortality. However, the AUCs and cutoff points in this study are smaller than those reported in the previous study [ 20 ], which is probably attributable to the larger sample size of the current study. In the present study, CSSS showed nearly the same ability in predicting the 4 outcomes of AP, and it shared nearly equal capacity with BISAP for predicting the outcomes of AP, which indicates that CSSS is a promising scoring system.…”

“…Biochemical markers measured within 48 h after admission were analysed. RS [ 23 ], GS [ 24 ], BISAP [ 25 ], PASS [ 19 ], and CSSS [ 20 ] were calculated for each patient within 48 h after admission. Scores were compared for their accuracy in the prediction of disease severity, mortality, and development of organ failure (ARDS and ARF).…”

“…A prospective cohort study [ 18 ] showed that the pancreatic activity scoring system (PASS; Table 1 ), which was first reported by the Southern California Pancreas Study Group in 2017 [ 19 ], could predict important clinical events at different points during the course of AP. Another new scoring system called the Chinese simple scoring system (CSSS; Table 2 ) was proposed in 2020 [ 20 ]. Both scoring systems are not yet widely used.…”

Accuracy of Conventional and Novel Scoring Systems in Predicting Severity and Outcomes in Acute Pancreatitis: A Retrospective Study

“…And cutoff points were 4 for severity and 6 for mortality. However, our study showed a smaller AUCs and smaller cutoff points cmparing to the original study [20]. This probably because sample size of out study was larger than that of the original study.…”

Evaluation of the modified computed tomography severity index (MCTSI) and computed tomography severity index (CTSI) in predicting severity and clinical outcomes in acute pancreatitis

“…The modified computer tomographic severity index (MCTSI) showed a better correlation than CTSI for clinical outcome and local complications. Other more recent scores, such as the bedside index for severity in acute pancreatitis (BISAP) score 14 and Chinese simple scoring system (CSSS), 15 have also been developed with promising outcomes.…”