Harmless_Acute_Pancreatitis_Score v.1

Identifies patients who do not require intensive care for their first episode of acute pancreatitis.

Jack msonkho

models@cambiocds.com

@CambioCDS

Identifying low risk patients with pancreatitis is notoriously difficult; a scoring system may help.

Patients with pancreatitis, particularly early in course. The observation looks at three variables with ordinal elements; PHematocrit ≥ 43% (male) or 39.6% (female), Creatinine ≥2 mg/dL (177 µmol/L) and Hematocrit ≥ 43% (male) or 39.6% (female). Hematocrit ≥ 43% (male) or 39.6% (female) has two options either it is absent or not. While the other two variables have the two conditional options of yes and no. Depending on whether the first variable is present or absent and the other two variables deserve a yes or no a selection is made. For the evaluation, depending on which ordinal variable is selected a score is applied to the selection. If a selection is either absent or the conditional option selected is no, then the values assigned is a zero. While if the selection is present or the conditional option is yes then a value of one is assigned accordingly. For the overall score assessment the total score of the selected ordinal values is added together and if the total is equal to zero then the result would be "Non-severe pancreatitis". While if the score were to be any number greater than or equal to one then the evaluation would be, "Scores >0 do not rule out a harmful first attack of acute pancreatitis. Consider further testing and possible admission to the ICU."

The HAPS should not be used in isolation to suggest that a patient will have a “harmless” course of pancreatitis, but may be an additional useful piece of data in otherwise low-risk patients. The HAPS is not designed to identify patients with high risk of pancreatitis, only those with low risk.

Lankisch, P. G., Weber-Dany, B., Hebel, K., Maisonneuve, P., & Lowenfels, A. B. (n.d.). The harmless acute pancreatitis score: a clinical algorithm for rapid initial stratification of nonsevere disease. Clinical Gastroenterology and Hepatology., 7(6), 702–5; quiz 607. https://doi.org/10.1016/j.cgh.2009.02.020 Validation Oskarsson V, et al. Validation of the harmless acute pancreatitis score in predicting nonsevere course of acute pancreatitis. Pancreatology. 2011;11(5):464-8. doi: 10.1159/000331502. Epub 2011 Sep 29.

OBSERVATION.harmless_acute_pancreatitis_score.v0, EVALUATION.harmless_acute_pancreatitis_score.v0