Validation of the efficacy of the prognostic factor score in the Japanese severity criteria for severe acute pancreatitis: A large multicenter study

Ikeura, Tsukasa; Horibe, Masayasu; Sanui, Masamitsu; Sasaki, Mitsuhito; Kuwagata, Yasuyuki; Nishi, Kenichiro; Kariya, Shuji; Sawano, Hirotaka; Goto, Takashi; Hamada, Tsuyoshi; Oda, Takuya; Yasuda, Hideto; Ogura, Yuki; Miyazaki, Dai; Hirose, Kaoru; Kitamura, Katsuya; Chiba, Nobutaka; Ozaki, Tetsu; Yamashita, Takahiro; Koinuma, Toshitaka; Oshima, Taku; Yamamoto, Tomonori; Hirota, Morihisa; Yamamoto, Satoshi; Oe, Kyoji; Ito, Tetsuya; Iwasaki, Eisuke; Kanai, Takanori; Okazaki, Kazuichi; Mayumi, Toshihiko

doi:10.1177/2050640616670566

Cited by 29 publications

(27 citation statements)

References 40 publications

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“…Although most patients with AP have the mild form of the disease, patients with moderate to severe AP, especially those who are admitted to the intensive care unit (ICU) due to organ failure, constitute a substantial burden to the Chinese medical system [4,5]. Early assessment of disease severity and prognosis is crucial in defining treatment strategies, because effective treatment can significantly reduce mortality in patients with AP [6].…”

Section: Introductionmentioning

confidence: 99%

High-density lipoprotein cholesterol to low-density lipoprotein cholesterol ratio in early assessment of disease severity and outcome in patients with acute pancreatitis admitted to the ICU

Zhong

et al. 2020

BMC Gastroenterol

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Section: Introductionmentioning

confidence: 99%

High-density lipoprotein cholesterol to low-density lipoprotein cholesterol ratio in early assessment of disease severity and outcome in patients with acute pancreatitis admitted to the ICU

Zhong

et al. 2020

BMC Gastroenterol

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“…It is important to evaluate the risk factors of early death in SAP [10]. The Japanese severity score (JSS) [11], which covers 18 risk factors, is generally used to assess the severity of AP and predict the progress of AP to SAP. However, the JSS was complex for clinical application.…”

Section: Discussionmentioning

confidence: 99%

Changes of serum neopterin and its significance as biomarker in prediction the prognosis of patients with acute pancreatitis

Zhang

Wang

Ji³

et al. 2020

Journal of Laboratory Medicine

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ObjectivesTo investigate the dynamic changes of serum neopterin and its significance as biomarker in prediction the prognosis of patients with acute pancreatitis.Methods54 cases with confirmed diagnosis of acute pancreatitis were included in the present work. Of the included 54 cases, 21 were mild acute pancreatitis and other 33 were server diseases. For the 33 severe cases, nine were finally dead and 24 were survived. The serological neopterin level of the 54 acute pancreatitis was continuously examined at the time point of days 0 (diagnosis), 1 (24 h after diagnosis), 2, 4, 8 and 14 by the enzyme linked immunosorbent assay (ELISA). The severity or death risk of the acute pancreatitis patients was predicted by the serological neopterin.ResultsThe serological neopterin was gradually increasing from days 0 to 8, but descending at day 14 in mild and survival groups. For days 8 and 14, the serological levels of neopterin in severe group were higher than those of mild group with statistical difference (p<0.05). The serum neopterin was statistical different in the time point of day 8 and day 14 between death and survival groups (p<0.05). For day 8, the serological neopterin as biomarker for death prediction sensitivity and specificity were 88.89% (95% CI: 51.75–99.72%) and 83.33% (95% CI: 62.62–95.26%) respectively with the AUC of 0.95 (95% CI: 0.88–1.00). For day 14, the death prediction sensitivity and specificity were 77.78% (33.99–97.19%) and 95.83% (78.88–99.89%) respectively with the AUC of 0.94 (95%CI:0.87–1.00).ConclusionsSerological neopterin level was elevated with the development of the pancreatitis. Continuously monitoring the serum neopterin may helpful for prediction death risk of acute pancreatitis. In the later phase of disease beginning on day 8, neopterin levels may be used for risk assessment and possibly change of therapy regiment.

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“…We read with great interest the article by Ikeura et al 1 assessing the efficacy of the prognostic factor score in the Japanese severity criteria for acute pancreatitis (AP). By analyzing 1159 patients with severe AP, they showed that the area under the curve (AUC) for the receiver‐operating characteristic curve of the prognostic factor score for predicting AP‐related mortality was 0.78, which was comparable to that for the well‐known acute physiology and chronic health evaluation (APACHE) II score (AUC = 0.80).…”

Section: Figurementioning

confidence: 99%

Severity assessment of acute pancreatitis using four prognostic factors – a nationwide multicenter study of 3682 cases in Japan

et al. 2017

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read with great interest the article by Ikeura et al.1 assessing the efficacy of the prognostic factor score in the Japanese severity criteria for acute pancreatitis (AP). By analyzing 1159 patients with severe AP, they showed that the area under the curve (AUC) for the receiver-operating characteristic curve of the prognostic factor score for predicting AP-related mortality was 0.78, which was comparable to that for the wellknown acute physiology and chronic health evaluation (APACHE) II score (AUC ¼ 0.80). One weakness of their study is that mild AP cases were not included in the analysis due to the study design. In addition, severity assessment using the nine factors might be too complicated. In Japan, the Research Committee of Intractable Pancreatic Diseases, under the support of the Ministry of Health, Labor, and Welfare of Japan, has conducted nationwide epidemiological surveys of AP including both severe and mild cases every 4-5 years.2-4 We recently reported that four (base excess or shock, renal failure, systemic inflammatory response syndrome criteria and age) out of the nine prognostic factors were associated with AP-related death by multivariate analysis in the 2011 survey.5 Here, we validated the utility of the severity assessment system based on these four factors in 3682 AP cases collected for the 2003 (285 cases), 2007 (1146 cases), and 2011 (2251 cases) surveys.We performed receiver-operating characteristic curve analysis to evaluate the predictive accuracy of the prognostic factor scores for mortality. The AUC was 0.80 for the nine prognostic factors. If the cut-off point was set at score ¼ 3 as adopted currently, the sensitivity was 0.47 with a specificity of 0.93. The AUC for predicting mortality was 0.78 for the four prognostic factors, suggesting the comparable utility of these four factors in the severity assessment. The sensitivity was 0.53 with a specificity of 0.92 if the cut-off point was set at score ¼ 2. If we define the patients fulfilling at least two out of the four prognostic factors as severe, 342/3682 (9.3%) patients had severe AP. The mortality of severe AP cases was 17.3% (59/342), whereas that of mild AP cases was 1.6% (52/3340) (Figure 1). If we choose only two factors (renal failure and age) that showed a stronger association with AP-related mortality among the four factors, 5 the AUC was decreased to 0.72. The sensitivity was 0.22 with a specificity of 0.98 if the cut-off point was set at score ¼ 2.Our results suggested that severity assessment using the four prognostic factors was equivalent to the current Japanese severity criteria employing nine factors. Accurate assessment of severity in patients with AP is

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Validation of the efficacy of the prognostic factor score in the Japanese severity criteria for severe acute pancreatitis: A large multicenter study

Cited by 29 publications

References 40 publications

High-density lipoprotein cholesterol to low-density lipoprotein cholesterol ratio in early assessment of disease severity and outcome in patients with acute pancreatitis admitted to the ICU

High-density lipoprotein cholesterol to low-density lipoprotein cholesterol ratio in early assessment of disease severity and outcome in patients with acute pancreatitis admitted to the ICU

Changes of serum neopterin and its significance as biomarker in prediction the prognosis of patients with acute pancreatitis

Severity assessment of acute pancreatitis using four prognostic factors – a nationwide multicenter study of 3682 cases in Japan

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