Introduction and Validation of a Novel Acute Pancreatitis Digital Tool Interrogating Large Pooled Data From 2 Prospectively Ascertained Cohorts
Por:
Paragomi, P, Spagnolo, D, Breze, C, Gougol, A, Talukdar, R, Kochhar, R, Goenka, M, Gulla, A, Gonzalez, J, Singh, V, Ferreira, M, Stevens, T, Barbu, S, Nawaz, H, Gutierrez, S, Zarnescu, N, Archibugi, L, Easler, J, Triantafyllou, K, Pelaez-Luna, M, Thakkar, S, Ocampo, C, De-Madaria, E, Cote, G, Wu, B, Pothoulakis, I, Haupt, M, Whitcomb, D and Papachristou, G
Publicada:
1 nov 2020
Resumen:
Objectives
Acute pancreatitis (AP) is a sudden onset, rapidly evolving inflammatory response with systemic inflammation and multiorgan failure (MOF) in a subset of patients. New highly accurate clinical decision support tools are needed to allow local doctors to provide expert care. Methods
Ariel Dynamic Acute Pancreatitis Tracker (ADAPT) is a digital tool to guide physicians in ordering standard tests, evaluate test results and model progression using available data, propose emergent therapies. The accuracy of the severity score calculators was tested using 2 prospectively ascertained Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience cohorts (pilot University of Pittsburgh Medical Center, n = 163; international, n = 1544). Results
The ADAPT and post hoc expert-calculated AP severity scores were 100% concordant in both pilot and international cohorts. High-risk criteria of all 4 severity scores at admission were associated with moderately-severe or severe AP and MOF (both P < 0.0001) and prediction of no MOF was 97.8% to 98.9%. The positive predictive value for MOF was 7.5% to 14.9%. Conclusions
The ADAPT tool showed 100% accuracy with AP predictive metrics. Prospective evaluation of ADAPT features is needed to determine if additional data can accurately predict and mitigate severe AP and MOF.
Filiaciones:
Paragomi, P:
Univ Pittsburgh, Dept Med, Div Gastroenterol Hepatol & Nutr, Med Ctr, Pittsburgh, PA USA
Spagnolo, D:
Ariel Precis Med, Pittsburgh, PA USA
Breze, C:
Ariel Precis Med, Pittsburgh, PA USA
Gougol, A:
Univ Pittsburgh, Dept Med, Div Gastroenterol Hepatol & Nutr, Med Ctr, Pittsburgh, PA USA
Talukdar, R:
Asian Inst Gastroenterol, Dept Gastroenterol, Hyderabad, India
Kochhar, R:
Postgrad Inst Med Educ & Res, Dept Gastroenterol, Chandigarh, India
Goenka, M:
Apollo Gleneagles Hosp Kolkata, Dept Gastroenterol, Kolkata, India
Gulla, A:
Vilnius Univ, Inst Clin Med, Dept Gastroenterol, Vilnius, Lithuania
Georgetown Univ Hosp, Dept Gastroenterol, Washington, DC 20007 USA
Gonzalez, J:
Univ Autonoma Nueva Leon, Dept Gastroenterol, Monterrey, Mexico
Singh, V:
Johns Hopkins Med Inst, Div Gastroenterol, Dept Med, Baltimore, MD USA
Ferreira, M:
Hosp Nacl Itaugua, Dept Gastroenterol, Itaugua, Paraguay
Stevens, T:
Cleveland Clin Fdn, Div Gastroenterol & Hepatol, Dept Med, 9500 Euclid Ave, Cleveland, OH 44195 USA
Barbu, S:
Univ Med & Pharm Iuliu Hatieganu, Dept Surg, Cluj Napoca, Romania
Nawaz, H:
Eastern Maine Med Ctr, Dept Gastroenterol, Bangor, ME USA
Gutierrez, S:
Hosp Nacl Prof Alejandro Posadas, Dept Gastroenterol, Buenos Aires, DF, Argentina
Zarnescu, N:
Carol Davila Univ Med & Pharm, Univ Emergency Hosp Bucharest, Dept Gastroenterol, Bucharest, Romania
Archibugi, L:
Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Dept Pancreatobiliary Endoscopy & Endosonog, Milan, Italy
Easler, J:
Indiana Univ Sch Med, Dept Gastroenterol, Div Gastroenterol, Indianapolis, IN 46202 USA
Triantafyllou, K:
Attikon Univ Gen Hosp, Dept Med, Athens, Greece
Pelaez-Luna, M:
Univ Autonoma Mexico, Inst Nacl Ciencias Med & Nutr Salvador, Dept Gastroenterol, Mexico City, DF, Mexico
Thakkar, S:
West Virginia Univ, Dept Gastroenterol, Morgantown, WV 26506 USA
Ocampo, C:
Hosp Gen Argudos Dr Cosme Argerich, Dept Surg, Buenos Aires, DF, Argentina
:
Alicante Univ Gen Hosp, Alicante Inst Hlth & Biomed Res ISABIAL, Dept Gastroenterol, Alicante, Spain
Cote, G:
Med Univ South Carolina, Dept Med, Div Gastroenterol, Charleston, SC 29425 USA
Wu, B:
Kaiser Permanente, Dept Med, Div Gastroenterol, Pasadena, CA USA
Pothoulakis, I:
Univ Pittsburgh, Dept Med, Div Gastroenterol Hepatol & Nutr, Med Ctr, Pittsburgh, PA USA
MedStar Washington Hosp Ctr, Dept Med, Washington, DC USA
Haupt, M:
Ariel Precis Med, Pittsburgh, PA USA
Whitcomb, D:
Univ Pittsburgh, Dept Med, Div Gastroenterol Hepatol & Nutr, Med Ctr, Pittsburgh, PA USA
Papachristou, G:
Ohio State Univ, Dept Internal Med, Div Gastroenterol Hepatol & Nutr, Columbus, OH 43210 USA
Green Accepted
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