The Value of Quick Sepsis-Related Organ Failure Assessment Scores in Patients With Acute Pancreatitis Who Present to Emergency Departments: A Three-Year Cohort Study.

Publication Title

Gastroenterology Res

Authors

Alexander Hallac, Providence Gastroenterology, Spokane, WA 99204, United States.Follow
Nishant Puri, Providence Sacred Heart Medical Center, Spokane, Washington, USA.Follow
David Applebury, Providence Internal Medicine Residency Spokane, Providence Sacred Heart Medical Center, Spokane, WA.Follow
Kurt Myers, Internal Medicine Residency, Spokane, WA, USAFollow
Parag Dhumal
Ashish Thatte
Wichit Srikureja, Providence Gastroenterology, Spokane, WA 99204, United States.Follow

Document Type

Article

Publication Date

4-1-2019

Keywords

Emergency department; Pancreatitis; Sepsis; Systemic inflammatory response syndrome; Triage

Abstract

Background: Distinguishing sepsis from other inflammatory syndromes continues to be a clinical challenge. The goal of risk stratification tools is to differentiate sepsis from other conditions. We compare the ability of quick sepsis-related organ failure assessment (qSOFA) and systemic inflammatory responses syndrome (SIRS) scores to predict prolonged length of stay (LOS) among patients who presented to the emergency department and hospital ward with acute pancreatitis (AP).

Methods: We compiled a retrospective database of all adult patients hospitalized for AP during 2015 - 2018 at a single tertiary care center. Independent

Results: The sensitivity and specificity of an SIRS score of 2 or greater for the detection of patients with prolonged LOS were 61% and 80%, respectively. The qSOFA score of 2 or greater corresponded to a diagnosis of significant AP with a specificity of 99% and a sensitivity of 4%. Multiple regression analysis demonstrated that each point increase in an SIRS score is associated with 2.24 days in additional hospital LOS. Interestingly, SIRS scores were found to correlate with the LOS, but not qSOFA.

Conclusion: The qSOFA is a tool designed to identify patients at high risk of mortality due to sepsis. The data suggest that as with sepsis, patients with AP who are triaged with only qSOFA could be underrecognized and subsequently undertreated. Secondarily, the data suggest that SIRS scoring has the potential to promptly predict how long patients with AP will stay in the hospital.

Area of Special Interest

Digestive Health

Specialty/Research Institute

Gastroenterology