title: The ability of current scoring systems in differentiating transient and persistent organ failure in patients with acute pancreatitis.
abstract: OBJECTIVE
  The purpose of this study is to investigate the accuracy of currently used scoring systems in differentiating transient and persistent organ failure in patients with acute pancreatitis (AP).
  
  
  METHODS
  In this retrospective study, 127 consecutive patients with AP and organ failure were included. Patients were divided into transient and persistent organ failure groups. The Acute Physiology and Chronic Health Examination II score, bedside index of severity in acute pancreatitis, harmless acute pancreatitis score, and modified Marshall scores within the first 24 hours of organ failure were collected, and their accuracy in predicting transient organ failure was assessed.
  
  
  RESULTS
  Transient organ failure occurred in 46 patients (36.2%). Fewer patients with transient organ failure initiated with multiple organ failure (13.0% vs 37.0%, P=.004) and renal failure (17.4% vs 44.4%, P=.002). In predicting transient organ failure, the area under the curves of the 4 scoring systems is from 0.66 to 0.71. The area under the curve of serum amylase was 0.78, which was slightly better than that of the modified Marshall and Acute Physiology and Chronic Health Examination II score and was significantly better than that of the bedside index of severity in acute pancreatitis and harmless acute pancreatitis score (P<.05).
  
  
  CONCLUSIONS
  Current scoring systems are not accurate enough in differentiating transient and persistent organ failure in patients with AP.
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Shiqi
authors.initials: S
authors.lastname: Wang
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Xiangying
authors.initials: X
authors.lastname: Feng
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Shujun
authors.initials: S
authors.lastname: Li
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Chaoxu
authors.initials: C
authors.lastname: Liu
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Bai
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Yu
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China. Electronic address: fengqx@fmmu.edu.cn.
authors.forename: Quanxin
authors.initials: Q
authors.lastname: Feng
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China. Electronic address: zhaoqc@fmmu.edu.cn.
authors.forename: Qingchuan
authors.initials: Q
authors.lastname: Zhao
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D019540:Area Under Curve; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D010195:Pancreatitis / Q000097:blood / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D051437:Renal Insufficiency / Q000209:etiology* / Q000401:mortality; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000681:Amylases
keywords: Acute pancreatitis; Organ failure; Prediction