title: The Pancreatitis Outcome Prediction (POP) Score: a new prognostic index for patients with severe acute pancreatitis.
abstract: OBJECTIVE
  Severe acute pancreatitis, defined as pancreatitis with distant organ dysfunction, is a condition carrying a high mortality and morbidity. Current outcome prediction scores are based on small populations, usually from single specialist centers. Some scores cannot be applied until several days into hospital admission. We thus sought to develop a new and more sensitive outcome prediction score--the Pancreatitis Outcome Prediction (POP) Score--for these high-risk patients.
  
  
  METHODS
  Retrospective cohort study of a large multicenter intensive care database.
  
  
  METHODS
  One hundred fifty-nine U.K. intensive care units.
  
  
  METHODS
  Participants were 2,462 patients admitted to intensive care units with severe acute pancreatitis.
  
  
  METHODS
  None.
  
  
  RESULTS
  Demographic, physiologic, and biochemical data collected within the first 24 hrs of intensive care unit admission were used to develop a risk prediction score using logistic regression. The six variables with the strongest relationship to hospital outcome--arterial pH, age, serum urea, mean arterial pressure, PaO2/FIO2 ratio, and total serum calcium (in order of decreasing impact)--produced a model with a prognostic discrimination (area under the receiver operating characteristic curve = 0.838) superior to other models. These six factors were used to develop an objectively weighted multivariate prognostic score ranging from 0 to 40 points.
  
  
  CONCLUSIONS
  Prognostic stratification of patients with severe acute pancreatitis requiring intensive care offers a useful audit tool to gauge unit performance and improve delineation of subsets for prospective trials. Prospective validation of this new outcome prediction score is required, preferably in different countries. The validity of the POP Score for either hospital or intensive care admission could also be tested and assessed for superiority over existing scores.
authors.affiliation: Intensive Care National Audit & Research Centre, Tavistock House, Tavistock Square, London, United Kingdom. david.harrison@icnarc.org
authors.forename: David A
authors.initials: DA
authors.lastname: Harrison
authors.forename: Giovanna
authors.initials: G
authors.lastname: D'Amico
authors.forename: Mervyn
authors.initials: M
authors.lastname: Singer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D006113:United Kingdom