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

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    URI
    http://hdl.handle.net/11287/595344
    Author
    Gillick, K
    Elbeltagi, Hadir
    Bhattacharya, Sayantan
    Date
    2016-01
    Journal
    Annals of the Royal College of Surgeons of England
    Type
    Journal Article
    Publisher
    Royal College of Surgeons
    DOI
    10.1308/rcsann.2015.0051
    Rights
    Archived with thanks to Annals of the Royal College of Surgeons of England
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    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 URL
    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
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    • 2016 RD&E publications
    • Upper Gastro-Intestinal Surgery

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