Document Detail

Prediction of mortality in acute pancreatitis: a systematic review of the published evidence.
MedLine Citation:
PMID:  19657215     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In this review, we focus on studies that examined such prognostic indices in relation to predicting a fatal outcome from pancreatitis.
SUMMARY BACKGROUND DATA: Acute pancreatitis (AP) is a common emergency, and early identification of high-risk patients can be difficult. For this reason, a plethora of different prognostic variables and scoring systems have been assessed to see if they can reliably predict the severity of pancreatitis and/or subsequent mortality.
METHODS: All studies that focused on AP, including retrospective series and prospective trials, were retrieved and analysed for factors that could influence mortality. Articles that analysed factors influencing the severity of the disease or the manifestation of disease-related complications were excluded.
RESULTS: 58 articles meeting the inclusion criteria were identified. Among the various factors investigated, APACHE II seemed to have the highest positive predictive value (69%). However, most prognostic variables and scores showed high negative predictive values but suboptimal values for positive predictive power.
CONCLUSIONS: Despite the proliferation of scoring systems for grading AP, none are ideal for the prediction of mortality. With the exception of the APACHE II, the other scores and indexes do not have a high degree of sensitivity, specificity and predictive values.
G Gravante; G Garcea; S L Ong; M S Metcalfe; D P Berry; D M Lloyd; A R Dennison
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-08-04
Journal Detail:
Title:  Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]     Volume:  9     ISSN:  1424-3911     ISO Abbreviation:  Pancreatology     Publication Date:  2009  
Date Detail:
Created Date:  2009-12-03     Completed Date:  2010-02-12     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100966936     Medline TA:  Pancreatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  601-14     Citation Subset:  IM    
Copyright Information:
Copyright 2009 S. Karger AG, Basel.
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MeSH Terms
Acute Disease
Outcome Assessment (Health Care)
Pancreatitis / diagnosis,  mortality*
Pancreatitis, Acute Necrotizing / mortality
Prospective Studies
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index

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