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Combination of APACHE-II score and an obesity score (APACHE-O) for the prediction of severe acute pancreatitis

Record type: Article

Background: The advent of specific therapeutic or preventive treatments for severe acute pancreatitis creates a need to determine the risk of complications for each individual. Scoring systems used in acute pancreatitis identify groups of patients at risk of complications, but the pancreatitis-specific scores require 48 h of hospital admission to give full information. The APACHE-II score is useful within 24 h, but ignores simple clinical features, such as obesity, known to predict severity. The aim of this study was to evaluate a combination of the APACHE-II score with an obesity score in patients with acute pancreatitis, to predict severity using information available during the first 24 h of hospital admission.
Methods: Data were collected prospectively from 186 consecutive patients with acute pancreatitis, to allow calculation of the APACHE-II score and body mass index (BMI). BMI was categorised as normal (score = 0), overweight (BMI 26-30: score = 1), or obese (BMI >30: score = 2). A logistic regression model was used to identify factors significantly associated with complications (Atlanta criteria; 104 complications in 60 patients).
Results: Age, BMI and the acute physiology score independently predicted complications. Addition of the score for obesity to the APACHE-II score gave a composite score (APACHE-O) with greater predictive accuracy. At cut-off of >8, APACHE-O had sensitivity 82%, specificity 86%, positive predictive value 74%, negative predictive value 91% and overall accuracy 85%.
Conclusions: This study confirms that age, obesity and APACHE-II measured in the first 24 h of hospital admission can predict complications in acute pancreatitis. Combination of the APACHE-II and obesity scores by simple addition improved categorical prediction of severity (mild or severe) in patients with acute pancreatitis.

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Citation

Johnson, C.D., Toh, S.K. and Campbell, M.J. (2004) Combination of APACHE-II score and an obesity score (APACHE-O) for the prediction of severe acute pancreatitis Pancreatology, 4, (1), pp. 1-6. (doi:10.1159/000077021).

More information

Published date: 2004
Keywords: apache scores, pancreatitis, obesity, body mass index

Identifiers

Local EPrints ID: 26406
URI: http://eprints.soton.ac.uk/id/eprint/26406
ISSN: 1424-3903
PURE UUID: a743efe9-b96b-4c0e-aa9c-9bf3eb28b972

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Date deposited: 24 Apr 2006
Last modified: 17 Jul 2017 16:07

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Contributors

Author: C.D. Johnson
Author: S.K. Toh
Author: M.J. Campbell

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