title: An evidence-based proposal for predicting organ failure in severe acute pancreatitis.
abstract: OBJECTIVE
  Early, efficient, and accurate evaluation for organ failure is an important step for improving outcome in severe acute pancreatitis (SAP). We aim to develop a method that can early, efficiently, and accurately evaluate the in-hospital organ failure in patients with SAP.
  
  
  METHODS
  Using multivariate logistic regression analysis, the associative factors for in-hospital organ failure were evaluated retrospectively from conventional data obtained from 393 patients with SAP from 2000 to 2012. In classification and regression tree analysis, a new clinical scoring system was developed for the evaluation of in-hospital organ failure in SAP. We also compared the accuracy of our new scoring system with multiple organ dysfunction score and Acute Physiology and Chronic Health Examination II score by the receiver operating characteristic curve.
  
  
  RESULTS
  Laboratory results revealed serum calcium level greater than or equal to 1.84 mmol/L, serum creatinine level greater than or equal to 110 µmol/L, age greater than or equal to 72 years, activated partial thromboplastin time less than or equal to 30.95 seconds, and Balthazar computed tomography score greater than or equal to 7 (CCAAB) score system, each contributed 1 point for the prediction of organ failure. The area under the curve of the CCAAB score system was similar to multiple organ dysfunction scores and Acute Physiology and Chronic Health Examination II scores.
  
  
  CONCLUSIONS
  The new scoring system CCAAB is an efficient and accurate method for the early evaluation of patients with SAP for in-hospital organ failure.
authors.affiliation: From the *Department of General Surgery, †Center for Pancreatic Disease, Division of Gastroenterology, Hepatology and Colorectal Disease, and ‡Department of Ultrasonography, the Fourth Center Hospital; §Radiological Department in General Hospital, ∥Center for Pancreatic Disease, Division of Gastroenterology, Hepatology and Colorectal disease, Department of Medicine, ¶Center of Evidence-Based Medicine, Department of Statistics and Epidemiology, College of Public Health, and #Department of Neuroendocrine and Metabolism Disease, the Metabolism Medicine Hospital, Tianjin Medical University; **Department of Hematology Medicine, and ††Center for Severe Pancreatic Disease, Division of Intensive Care Unit, the Fourth Center Hospital; ‡‡Center for Hematic Disease Laboratory, Tianjin Medical University, Tianjin; and §§Department of International Herald Leader, Xin Hua News Agency, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Yaling
authors.initials: Y
authors.lastname: Xu
authors.forename: Yuwen
authors.initials: Y
authors.lastname: Qiao
authors.forename: Xiuying
authors.initials: X
authors.lastname: Pang
authors.forename: Liang
authors.initials: L
authors.lastname: Hong
authors.forename: Jie
authors.initials: J
authors.lastname: Fu
authors.forename: Yueguang
authors.initials: Y
authors.lastname: Li
authors.forename: Zhang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Cui
authors.forename: Hechao
authors.initials: H
authors.lastname: Li
authors.forename: Weisheng
authors.initials: W
authors.lastname: Wang
authors.forename: Hua
authors.initials: H
authors.lastname: Pang
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D003401:Creatine / Q000097:blood; D042241:Early Diagnosis; D019317:Evidence-Based Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000150:complications* / Q000473:pathology; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003401:Creatine; D002118:Calcium