Predictive value of Systemic Inflammatory Response Syndrome score in assessing the clinical outcomes in patients with acute pancreatitis

Nam-Hun Jong; Mi-Hua Hyon; Nam Yu; Hye-Song Kim; Chung-Song Pak; Song-Huan Kim

Abstract

Background: The role of various clinical scoring systems to assess the severity and outcomes of acute pancreatitis is attracting a lot of attention to the experts. Purpose: We aimed to objectively reconfirm the predictive value of systemic inflammatory response syndrome (SIRS) score for predicting the various clinical outcomes of acute pancreatitis and also to evaluate the significance of monitoring SIRS score on day 1 and its duration. Methods: We retrospectively analyzed data collected from 219 patients with acute pancreatitis who were admitted to our hospital on day 1 of onset between January 2017 and December 2019. The incidence and time course of SIRS score were evaluated with the markers of severity and clinical outcomes. Results: SIRS occurred in 95/219 patients (43.4%) on day 1. As the SIRS score on day 1 increased, the incidence of acute necrotic fluid collection, organ failures and other adverse clinical outcomes increased significantly(p<0.05). SIRS score on day 1 had high predictive value to predict the clinical outcomes (AUC 0.789-0.870) and the optimal cutoff number determined by Receiver Operating Characteristic Curve was 2, as the same as the standard cutoff. Persistent SIRS predicted the adverse outcomes of acute pancreatitis with high accuracy (AUC 0.864-0.919) and it was superior to SIRS score on day 1 in specificity (57.9%-72% vs 74.8%-92.5%; p<0.05) and positive predictive value (5.3%-52.6% vs 8.5%-79.6%). Conclusion: The measurement of SIRS score on the first day of hospitalization and monitoring the duration of SIRS can provide important information in predicting the clinical outcomes of the patients with acute pancreatitis

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