Assessment Of Clinical Criteria For Poor Outcomes In Patients With Acute Pancreatitis And Infections

Background:Patients with acute pancreatitis(AP)have a high risk of infection,which is the main cause for death.Sepsis has been redefined,and quick sequential organ failure assessment(qSOFA)criteria have been proposed to identify potential infections in patients at risk for poor outcomes.This study aimed to discuss the value of qSOFA,systemic inflammatory response syndrome(SIRS),and bedside index for severity in acute pancreatitis(BISAP)criteria for predicting poor prognosis in patients with AP and infections.Methods:In total,171 patients with AP and infections were included in this retrospective study.Demographic,laboratory,and microbiological data were collected at the time of diagnosis of infection.The scores of q SOFA,SIRS,and BISAP were calculated,and the area under ROC curves for 28-day mortality was analyzed.Univariate and multivariate Cox regression analyses were performed to predict organ failure.Results:Among the 171 patients,13(7.6%)patients died,and 51(29.8%)patients experienced organ failure.There were significantly difference between qSOFA criteria with BISAP criteria for 28-day mortality(P<0.001).The area under the ROC curves of qSOFA criteria and BISAP criteria were 0.805(95%CI 0.661-0.948,P<0.001),and 0.930(95% CI 0.874-0.985,P<0.001),respectively,which were significantly higher than the SIRS criteria(0.689,95%CI0.577-0.801,P=0.023).q SOFA criteria(sHR 2.080,95%CI 1.325-3.264,P=0.001),and BISAP criteria(s HR 1.749,95%CI 1.230-2.486,P=0.002)were the independent predictors of organ failure.Conclusions:BISAP criteria and qSOFA criteria can predict the poor outcomes of patients with AP and infections.The predictive value of the BISAP criteria is higher,but the qSOFA criteria is more convenient.