Evaluation And Establishment Of Acute Pancreatitis Severity Prediction Model Based On Modified Early Warning Scoring System And D-dimer

Objective: To explore the value of modified early warning scoring system（MEWS）and D-dimer in predicting the severity of acute pancreatitis（AP）,establish a new scoring system based on mews and D-dimer,and evaluate its ability to predict the severity of AP.Methods: AP patients in the Second Affiliated Hospital of Anhui Medical University from January 1,2017 to December 31,2018 were selected as the research objects.The data collected included: general information of patients,serological indexes within 48 hours after admission and mews score.According to the severity of clinical symptoms and organ failure,the patients were divided into two groups: mild acute pancreatitis（map）and non mild acute pancreatitis（MSAP + severe acute pancreatis,SAP）.Study one: compare the levels of various serological indexes in the two groups,calculate the area under the curve（AUC）according to the receiver operating characteristic（ROC）,and evaluate the predictive value of various serological indexes.Study two: evaluate the value of mews and D-dimer alone in predicting the severity of AP,including sensitivity,specificity and accuracy.Combined mews and D-dimer to establish a new scoring system and evaluate its ability to predict severe AP.Results: Study one: 158 patients with AP were included in the study.The leukocyte count,percentage of neutrophils,serum albumin,blood calcium,fibrinogen and D-dimer in MSAP + SAP group were significantly higher than those in map group.The AUC of non mild AP predicted by each index were 0.662,0.618,0282,0.286,0.634 and 0.672 respectively.Among them,d-polymer has the highest predictive value.Study two: 357 patients with AP were included in the study.According to the ROC curve,the AUCs of D-dimer,mews and the new model were 0.702,0.628 and 0.734,respectively（P < 0.05）.The sensitivity of the new model to predict non mild AP was 79.7%.The AUC value of non mild AP predicted by the new model was higher than that of mews and D-Dimer（P < 0.05）.Conclusion: The new model based on mews and D-dimer is better than mews and D-dimer in predicting the severity of AP.The new model is simple,cheap and more suitable for clinical use.