ArticleOpen access emergency medicine : OAEM2022
Clinical Prediction Score for Early Diagnosis of Acute Pancreatitis in Emergency Departments.
Article in Open access emergency medicine : OAEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 3 citations in OpenAlex.
- Emergency patients with mild elevations of serum lipase and acute pancreatitis.Saudi medical journal · 2025Article
- Integration of Immune Cell Signatures and Diagnostic Gene Markers in Pancreatitis: A Comprehensive Study on Therapeutic Targets and Predictive Diagnosis.Human mutation · 2025Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In Thailand, most primary care hospitals cannot measure serum lipase and amylase; no 24 hours computed tomography and magnetic resonance imaging available, and no on-call gastroenterologists. Thus, acute pancreatitis cannot be diagnosed based on the established diagnostic criteria that require this information. The resultant delayed management increases morbidity and mortality. This study was performed to create a clinical prediction score for early diagnosis of acute pancreatitis in emergency departments without requiring a computed tomography scan or laboratory measurement to assist in the initial diagnosis, treatment, or referral. Methods: Patients with suspected acute pancreatitis who had available data regarding lipase and amylase measurements and visited the emergency department from June 2019 to August 2020 were retrospectively analyzed. The baseline predictive factors were compared between patients with and without acute pancreatitis according to the 2012 revised Atlanta classification. Multivariable logistic regression was used to explore potential predictive factors and develop a clinical prediction score for the diagnosis of acute pancreatitis. Results: A total of 506 eligible patients, 84 (16%) had acute pancreatitis. The PRE-PAN score [area under the receiver operating characteristics curve, 0.88; 95% confidence interval (CI), 0.84-0.93] included six factors: alcohol drinking, epigastric pain, pain radiating to the back, persistent pain, nausea or vomiting, and the pain score. A score of >7.5 points suggested a high probability of acute pancreatitis [positive likelihood ratio, 6.80 (95% CI, 4.75-9.34; p < 0.001); sensitivity, 66.7% (95% CI, 54.6-77.3); specificity, 90.2% (95% CI, 86.6-93.1); positive predictive value, 58.5% (95% CI, 47.1-69.3);, 92.9% (95% CI, 89.6-95.4)]. Conclusion: A PRE-PAN risk score is a screening tool for predicting acute pancreatitis without using the lipase concentration or radiological findings. A high predictive score, especially >7.5, suggests a high probability of acute pancreatitis.
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