Waterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis.

2.50
Hdl Handle:
http://hdl.handle.net/11287/595344
Title:
Waterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis.
Authors:
Gillick, K; Elbeltagi, Hadir; Bhattacharya, Sayantan
Abstract:
Introduction Introduced originally to stratify risk for developing decubitus ulcers, the Waterlow scoring system is recorded routinely for surgical admissions. It is a composite score, reflecting patients' general condition and co-morbidities. The aim of this study was to investigate whether the Waterlow score can be used as an independent surrogate marker to predict severity and adverse outcome in acute pancreatitis. Methods In this retrospective analysis, a consecutive cohort was studied of 250 patients presenting with acute pancreatitis, all of whom had their Waterlow score calculated on admission. Primary outcome measures were length of hospital stay and mortality. Secondary outcome measures included rate of intensive care unit (ICU) admission and development of complications such as peripancreatic free fluid, pancreatic necrosis and pseudocyst formation. Correlation of the Waterlow score with some known markers of disease severity and outcomes was also analysed. Results The Waterlow score correlated strongly with the most commonly used marker of disease severity, the Glasgow score (analysis of variance, p=0.0012). Inpatient mortality, rate of ICU admission and length of hospital stay increased with a higher Waterlow score (Mann-Whitney U test, p=0.0007, p=0.049 and p=0.0002 respectively). There was, however, no significant association between the Waterlow score and the incidence of three known complications of pancreatitis: presence of peripancreatic fluid, pancreatic pseudocyst formation and pancreatic necrosis. Receiver operating characteristic curve analysis demonstrated good predictive power of the Waterlow score for mortality (area under the curve [AUC]: 0.73), ICU admission (AUC: 0.65) and length of stay >7 days (AUC: 0.64). This is comparable with the predictive power of the Glasgow score and C-reactive protein. Conclusions The Waterlow score for patients admitted with acute pancreatitis could provide a useful tool in prospective assessment of disease severity, help clinicians with appropriate resource management and inform patients.
Citation:
Waterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis. 2016, 98 (1):61-6 Ann R Coll Surg Engl
Publisher:
Royal College of Surgeons
Journal:
Annals of the Royal College of Surgeons of England
Issue Date:
Jan-2016
URI:
http://hdl.handle.net/11287/595344
DOI:
10.1308/rcsann.2015.0051
PubMed ID:
26688403
Additional Links:
http://publishing.rcseng.ac.uk/doi/abs/10.1308/rcsann.2015.0051?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Type:
Journal Article
Language:
en
ISSN:
1478-7083
Appears in Collections:
Upper Gastro-Intestinal Surgery; 2016 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorGillick, Ken
dc.contributor.authorElbeltagi, Hadiren
dc.contributor.authorBhattacharya, Sayantanen
dc.date.accessioned2016-02-01T13:38:01Zen
dc.date.available2016-02-01T13:38:01Zen
dc.date.issued2016-01en
dc.identifier.citationWaterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis. 2016, 98 (1):61-6 Ann R Coll Surg Englen
dc.identifier.issn1478-7083en
dc.identifier.pmid26688403en
dc.identifier.doi10.1308/rcsann.2015.0051en
dc.identifier.urihttp://hdl.handle.net/11287/595344en
dc.description.abstractIntroduction Introduced originally to stratify risk for developing decubitus ulcers, the Waterlow scoring system is recorded routinely for surgical admissions. It is a composite score, reflecting patients' general condition and co-morbidities. The aim of this study was to investigate whether the Waterlow score can be used as an independent surrogate marker to predict severity and adverse outcome in acute pancreatitis. Methods In this retrospective analysis, a consecutive cohort was studied of 250 patients presenting with acute pancreatitis, all of whom had their Waterlow score calculated on admission. Primary outcome measures were length of hospital stay and mortality. Secondary outcome measures included rate of intensive care unit (ICU) admission and development of complications such as peripancreatic free fluid, pancreatic necrosis and pseudocyst formation. Correlation of the Waterlow score with some known markers of disease severity and outcomes was also analysed. Results The Waterlow score correlated strongly with the most commonly used marker of disease severity, the Glasgow score (analysis of variance, p=0.0012). Inpatient mortality, rate of ICU admission and length of hospital stay increased with a higher Waterlow score (Mann-Whitney U test, p=0.0007, p=0.049 and p=0.0002 respectively). There was, however, no significant association between the Waterlow score and the incidence of three known complications of pancreatitis: presence of peripancreatic fluid, pancreatic pseudocyst formation and pancreatic necrosis. Receiver operating characteristic curve analysis demonstrated good predictive power of the Waterlow score for mortality (area under the curve [AUC]: 0.73), ICU admission (AUC: 0.65) and length of stay >7 days (AUC: 0.64). This is comparable with the predictive power of the Glasgow score and C-reactive protein. Conclusions The Waterlow score for patients admitted with acute pancreatitis could provide a useful tool in prospective assessment of disease severity, help clinicians with appropriate resource management and inform patients.en
dc.language.isoenen
dc.publisherRoyal College of Surgeonsen
dc.relation.urlhttp://publishing.rcseng.ac.uk/doi/abs/10.1308/rcsann.2015.0051?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmeden
dc.rightsArchived with thanks to Annals of the Royal College of Surgeons of Englanden
dc.subjectWessex Classification Subject Headings::Surgeryen
dc.titleWaterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis.en
dc.typeJournal Articleen
dc.identifier.journalAnnals of the Royal College of Surgeons of Englanden
dc.type.versionPublisheden

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