Liengswangwong et al reported a clinical prediction score for the early diagnosis of acute pancreatitis in an Emergency Department. This can help to guide the initial workup and management in a resource limited setting. The authors are from Mahidol University in Bangkok.
PRE-PAN is derived from predicting pancreatitis.
Use: emergency department without serum enzyme testing or 24-hour imaging services
Parameters:
(1) alcohol drinking (may need to be weighted to exclude minor alcohol intake)
(2) epigastric pain
(3) pain radiating to the back
(4) persistent pain
(5) nausea and/or vomiting
(6) pain intensity along a VAS scale, from 0 to 10
Parameter
Finding
Points
alcohol drinking
no
0
yes
1.5
epigastric pain
no
0
yes
2
pain radiating to back
no
0
yes
1
persistent pain
no
0
yes
2.5
nausea and/or vomiting
no
0
yes
1.5
pain
mild (0 to 3)
0
moderate (4 to 6)
1.5
severe (7 to 10)
2.5
total score =
= SUM(points for all of the scores)
Interpretation:
• minimum score: 0
• maximum score: 11
Score
Risk Category
% Acute Pancreatitis
0 to 4.5
low
4%
5 to 7.5
moderate
29%
8 to 11
high
67%
Performance:
• The area under the ROC curve is 0.88.
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