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Japanese severity score for acute pancreatitis well predicts in-hospital mortality: a nationwide survey of 17,901 cases

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Early identification of severe cases of acute pancreatitis is necessary to reduce mortality. The Japanese severity score, which consists of nine prognostic factors, is reported to be useful for assessment of acute pancreatitis severity, but has not been validated by large-scale data.

Methods

Data on adult patients with acute pancreatitis were collected between July 1, 2010, and September 30, 2011, from a national administrative database covering 1,032 Japanese hospitals. In-hospital mortality was analyzed to evaluate the predictive value of the Japanese severity score.

Results

A total of 17,901 patients were included. Total in-hospital mortality was 2.6 %, and mortality rates of non-severe and severe acute pancreatitis were 1.1 and 7.0 %, respectively (P < 0.001). In multivariate analysis with adjustment for other baseline characteristics, the odds ratio for mortality significantly increased according to an increase in prognostic factor score. The odds ratio for mortality of computed tomography grade 3 was significantly higher than that of grade 1 (P < 0.001), but that of grade 2 was not (P = 0.149). In receiver operating characteristic curve analysis of the prognostic factor score for prediction of in-hospital mortality, the area under the curve was 0.798 (95 % confidence interval 0.775–0.821), and the optimum cutoff level of the prognostic factors was 2, in accordance with the definition of the current scoring system.

Conclusions

The prognostic factor score has good predictive value for in-hospital mortality of acute pancreatitis, and thus is useful for severity assessment of acute pancreatitis at the early stage of hospital admission.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Tsuyoshi Hamada, Yousuke Nakai, Hiroyuki Isayama & Kazuhiko Koike

  2. Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Hideo Yasunaga & Hiromasa Horiguchi

  3. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan

    Kiyohide Fushimi

Authors
  1. Tsuyoshi Hamada
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  2. Hideo Yasunaga
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  3. Yousuke Nakai
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  4. Hiroyuki Isayama
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  5. Hiromasa Horiguchi
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  6. Kiyohide Fushimi
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  7. Kazuhiko Koike
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Correspondence to Hiroyuki Isayama.

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Hamada, T., Yasunaga, H., Nakai, Y. et al. Japanese severity score for acute pancreatitis well predicts in-hospital mortality: a nationwide survey of 17,901 cases. J Gastroenterol 48, 1384–1391 (2013). https://doi.org/10.1007/s00535-013-0765-6

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  • DOI: https://doi.org/10.1007/s00535-013-0765-6

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