title: Japanese severity score for acute pancreatitis well predicts in-hospital mortality: a nationwide survey of 17,901 cases.
abstract: BACKGROUND
  Early identification of severe cases of acute pancreatitis is necessary to reduce mortality. The Japanese severity score, which consists of nine prognostic factors, is reported to be useful for assessment of acute pancreatitis severity, but has not been validated by large-scale data.
  
  
  METHODS
  Data on adult patients with acute pancreatitis were collected between July 1, 2010, and September 30, 2011, from a national administrative database covering 1,032 Japanese hospitals. In-hospital mortality was analyzed to evaluate the predictive value of the Japanese severity score.
  
  
  RESULTS
  A total of 17,901 patients were included. Total in-hospital mortality was 2.6%, and mortality rates of non-severe and severe acute pancreatitis were 1.1 and 7.0%, respectively (P < 0.001). In multivariate analysis with adjustment for other baseline characteristics, the odds ratio for mortality significantly increased according to an increase in prognostic factor score. The odds ratio for mortality of computed tomography grade 3 was significantly higher than that of grade 1 (P < 0.001), but that of grade 2 was not (P = 0.149). In receiver operating characteristic curve analysis of the prognostic factor score for prediction of in-hospital mortality, the area under the curve was 0.798 (95% confidence interval 0.775-0.821), and the optimum cutoff level of the prognostic factors was 2, in accordance with the definition of the current scoring system.
  
  
  CONCLUSIONS
  The prognostic factor score has good predictive value for in-hospital mortality of acute pancreatitis, and thus is useful for severity assessment of acute pancreatitis at the early stage of hospital admission.
authors: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Tsuyoshi
authors: T
authors: Hamada
authors: Hideo
authors: H
authors: Yasunaga
authors: Yousuke
authors: Y
authors: Nakai
authors: Hiroyuki
authors: H
authors: Isayama
authors: Hiromasa
authors: H
authors: Horiguchi
authors: Kiyohide
authors: K
authors: Fushimi
authors: Kazuhiko
authors: K
authors: Koike
mesh_terms: D000208:Acute Disease; D000328:Adult; D016208:Databases, Factual; D042241:Early Diagnosis; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed