Rasch et al reported the Emergency Room Assessment of Acute Pancreatitis (ERAP) for quickly evaluating a patient with acute pancreatitis in the Emergency Department. This can help to identify a patient who may benefit from more aggressive management. The authors are from Technische Universitat Munchen.
Patient selection: acute pancreatitis
Parameters:
(1) respiratory rate in breaths per minute
(2) Glasgow coma scale (GCS)
(3) serum urea in mmol/L
(4) serum CRP in mg/dL
Parameter
Finding
Points
respiratory rate
<= 21 breaths per minute
0
> 21 breaths per minute
1
Glasgow coma scale
15
0
3 to 14
1
serum urea
<= 8.9 mmol/L
0
> 8.9 mmol/L
1
serum CRP
<= 15 mg/dL
0
> 15 mg/dL
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• An ERAP >=2 is associated with multi-organ dysfunction (sensitivity 0.83, specificity 0.95) and mortality (sensitivity 0.80, specificity 0.94).
Performance:
• The area under the ROC curve was 0.96 for MODS and 0.95 for mortality.
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