A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department

Qiang Lai,1– 3 Wei Wei,1– 3 Yarong He,1– 3 Tao Cheng,1– 3 Tianyong Han,1– 3 Yu Cao1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s...

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Main Authors: Lai Q, Wei W, He Y, Cheng T, Han T, Cao Y
Format: Article
Language:English
Published: Dove Medical Press 2022-09-01
Series:Journal of Inflammation Research
Subjects:
Online Access:https://www.dovepress.com/a-rapid-prognostic-score-based-on-bedside-arterial-blood-gas-analysis--peer-reviewed-fulltext-article-JIR
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author Lai Q
Wei W
He Y
Cheng T
Han T
Cao Y
author_facet Lai Q
Wei W
He Y
Cheng T
Han T
Cao Y
author_sort Lai Q
collection DOAJ
description Qiang Lai,1– 3 Wei Wei,1– 3 Yarong He,1– 3 Tao Cheng,1– 3 Tianyong Han,1– 3 Yu Cao1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yu Cao, Emergency Department, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, People’s Republic of China, Email yuyuer@126.comObjective: To establish a rapid and concise prognosis scoring system for pancreatitis in the emergency department based on bedside arterial blood gas analysis (ABG).Methods: A single-center, retrospective cohort study was used to establish the new scoring system, and a validation group was used to verify it. The primary endpoint was 60-day death, and secondary endpoints were 28-day death, admission to the intensive care unit (AICU), requirement for mechanical ventilation (MV) and persistent organ failure (POF). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the new scoring system. The performance of the new scoring system was compared with that of conventional predictive scoring.Results: 443 patients were in the derivation group and 217 patients in the validation group, of which 27 and 25 died during follow-up. A total of 443 patients in the derivation group, 27 of whom died during the follow-up period. Multivariate regression analysis showed that mental status, hematocrit (HCT), base excess (BE) and Serum ionic calcium (Ca2+) were independent risk factors for 60-day mortality of pancreatitis, and they were used to create a new scoring system (MHBC). In the derivation and validation, the ability of MHBC (AUC= 0.922, 0.773, respectively) to predict 60-day mortality from pancreatitis was no less than that of APACHE II (AUC= 0.838, 0.748, respectively) and BISAP (AUC= 0.791, 0.750, respectively), while, MHBC is more quickly and concisely than APACHE II and BISAP. Compared with MHBC less than or equal to 2, when MHBC is greater than 2, the 28-day mortality, 60-day mortality and the incidence of AICU, MV and POF increased significantly (P < 0.001).Conclusion: The MHBC can quickly and concisely evaluate the 60-day mortality, 28-day mortality, and the incidence of AICU, MV and POF of patients with acute pancreatitis in the emergency department.Keywords: acute pancreatitis, prognosis, emergency department, arterial blood gas analysis, ABG
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spelling doaj.art-2a3099ade44a4f37897c192b36e8e3222022-12-22T04:03:15ZengDove Medical PressJournal of Inflammation Research1178-70312022-09-01Volume 155337534678271A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency DepartmentLai QWei WHe YCheng THan TCao YQiang Lai,1– 3 Wei Wei,1– 3 Yarong He,1– 3 Tao Cheng,1– 3 Tianyong Han,1– 3 Yu Cao1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yu Cao, Emergency Department, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, People’s Republic of China, Email yuyuer@126.comObjective: To establish a rapid and concise prognosis scoring system for pancreatitis in the emergency department based on bedside arterial blood gas analysis (ABG).Methods: A single-center, retrospective cohort study was used to establish the new scoring system, and a validation group was used to verify it. The primary endpoint was 60-day death, and secondary endpoints were 28-day death, admission to the intensive care unit (AICU), requirement for mechanical ventilation (MV) and persistent organ failure (POF). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the new scoring system. The performance of the new scoring system was compared with that of conventional predictive scoring.Results: 443 patients were in the derivation group and 217 patients in the validation group, of which 27 and 25 died during follow-up. A total of 443 patients in the derivation group, 27 of whom died during the follow-up period. Multivariate regression analysis showed that mental status, hematocrit (HCT), base excess (BE) and Serum ionic calcium (Ca2+) were independent risk factors for 60-day mortality of pancreatitis, and they were used to create a new scoring system (MHBC). In the derivation and validation, the ability of MHBC (AUC= 0.922, 0.773, respectively) to predict 60-day mortality from pancreatitis was no less than that of APACHE II (AUC= 0.838, 0.748, respectively) and BISAP (AUC= 0.791, 0.750, respectively), while, MHBC is more quickly and concisely than APACHE II and BISAP. Compared with MHBC less than or equal to 2, when MHBC is greater than 2, the 28-day mortality, 60-day mortality and the incidence of AICU, MV and POF increased significantly (P < 0.001).Conclusion: The MHBC can quickly and concisely evaluate the 60-day mortality, 28-day mortality, and the incidence of AICU, MV and POF of patients with acute pancreatitis in the emergency department.Keywords: acute pancreatitis, prognosis, emergency department, arterial blood gas analysis, ABGhttps://www.dovepress.com/a-rapid-prognostic-score-based-on-bedside-arterial-blood-gas-analysis--peer-reviewed-fulltext-article-JIRacute pancreatitisprognosisemergency departmentarterial blood gas analysisabg
spellingShingle Lai Q
Wei W
He Y
Cheng T
Han T
Cao Y
A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department
Journal of Inflammation Research
acute pancreatitis
prognosis
emergency department
arterial blood gas analysis
abg
title A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department
title_full A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department
title_fullStr A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department
title_full_unstemmed A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department
title_short A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department
title_sort rapid prognostic score based on bedside arterial blood gas analysis abg established for predicting 60 day adverse outcomes in patients with acute pancreatitis in the emergency department
topic acute pancreatitis
prognosis
emergency department
arterial blood gas analysis
abg
url https://www.dovepress.com/a-rapid-prognostic-score-based-on-bedside-arterial-blood-gas-analysis--peer-reviewed-fulltext-article-JIR
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