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. 2018 Feb;97(7):e9654.
doi: 10.1097/MD.0000000000009654.

Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis

Yu-San Tee  1 , Hsin-Yueh Fang, I-Ming Kuo, Yann-Sheng Lin, Song-Fong Huang, Ming-Chin Yu
Affiliations

Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis

Yu-San Tee et al. Medicine (Baltimore). 2018 Feb.

Abstract

Acute severe pancreatitis caused high mortality, and several scoring systems for predicting mortality are available. We evaluated the effectiveness of serial measurement of several scoring systems in patients with acute severe pancreatitis.We retrospectively obtained serial measurements of Ranson, Acute Physiology and Chronic Health Assessment (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scores of 159 patients with acute severe pancreatitis.The overall mortality rate was 20%, and early mortality (in the first 2 weeks) occurred in 10 (7.4%) patients, while late mortality occurred in 17 (12.6%).All scoring systems were reliable for predicting overall and intensive care unit mortality, while the SOFA score on day 7 presented the largest area under the receiver operator characteristic (ROC) curve (0.858, SE 0.055). Changes in scores over time were evaluated for predicting the progression of organ failure, and the change in SOFA score on hospital day 7 or no interval change in SOFA score was associated with higher mortality rates.APACHE II and SOFA scores are both sensitive for predicting mortality in acute pancreatitis. The serial SOFA scores showed reliable for predicting mortality. Hospital day 7 is a reasonable time for SOFA score reassessment to predict late mortality in acute severe pancreatitis.

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Conflict of interest statement

The authors have no conflict of interests.

Figures

Figure 1
Figure 1
Comparison of the area under the receiver operating characteristic curve for predicting (A) overall mortality and (B) ICU mortality in patients presenting with acute pancreatitis. APACHE = Acute Physiology and Chronic Health Assessment, ICU = intensive care unit, SOFA = Sequential Organ Failure Assessment.
Figure 2
Figure 2
Comparison of the area under the receiver operating characteristic curve for predicting (A) early mortality and (B) late mortality in patients presenting with acute pancreatitis.
Figure 3
Figure 3
Changes in APACHE II and SOFA scores in relation to mortality. APACHE = Acute Physiology and Chronic Health Assessment, SOFA = Sequential Organ Failure Assessment.
Figure 4
Figure 4
Correlation between SOFA score on day 7 and late mortality. SOFA = Sequential Organ Failure Assessment.
Figure 5
Figure 5
Comparison of AUROCs of scoring systems (A) on admission (B) interval follow-up for prediction of overall mortality in patients with acute pancreatitis. APACHE II score at 48th hour is one of the best prediction model currently, but APACHE II at 48 hours and SOFA score at day 7 both were good at prediction in serial evaluation.
See this image and copyright information in PMC

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