Élaboration d'un score prédictif précoce de sévérité des pancréatites aigües

Abstract : Background: acute pancreatitis is a common disease that can evolve in 10 to 20% of cases to a severe form whose mortality can reach up to 50%. The identification of patients at risk of developing a severe form is a major issue in order to initiate early appropriate treatment. The aim of this study was to identify clinical and biological factors at admission associated with severe form in order to develop a predictive severity score. Methods: we conducted a retrospective study at Caen University Hospital between January 2014 and December 2017, including 504 patients hospitalized for acute pancreatitis including 74 severe forms. We developed a predictive score named ASAP based on clinical-biological parameters associated with severe form in multivariate analysis. We validated our score in an independent validation cohort of 65 patients. Results: temperature, heart rate, albumin and creatinine clearance were significantly associated with severe form. The ASAP score showed an interesting predictive accuracy (AUROC at 0.83) significantly higher than SOFA, persistent SIRS and Balthazar. Using the -1.8575 threshold, the ASAP score had a sensitivity of 75%, a specificity of 76% and a negative predictive value of 95%. These predictive performances were confirmed in the validation cohort. Conclusion : the ASAP score based on simple clinical-biological parameters, demonstrate interesting predictive accuracy in order to distinguish severe form of acute pancreatitis.
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  • HAL Id : dumas-02045121, version 1

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Élise Vannier. Élaboration d'un score prédictif précoce de sévérité des pancréatites aigües. Médecine humaine et pathologie. 2018. ⟨dumas-02045121⟩

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