Development and validation of a novel clinical scoring system for short‐term prediction of death in dogs with acute pancreatitis
Male
610
severity
610 Medicine & health
hypocalcemia
Sensitivity and Specificity
Cohort Studies
0403 veterinary science
Dogs
Respiratory Rate
Heart Rate
Predictive Value of Tests
Risk Factors
Animals
Dog Diseases
Retrospective Studies
[SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health
creatinine;coagulation disorders;hypocalcemia;prognosis;severity;systemic inflammatory response syndrome
630 Agriculture
Hypocalcemia
creatinine
[SDV.BA.MVSA] Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health
600
04 agricultural and veterinary sciences
Survival Analysis
Systemic Inflammatory Response Syndrome
3. Good health
systemic inflammatory response syndrome
Médecine vétérinaire et santé animal
Pancreatitis
ROC Curve
coagulation disorders
Acute Disease
570 Life sciences; biology
Veterinary medicine and animal Health
Female
prognosis
SMALL ANIMAL
DOI:
10.1111/jvim.15421
Publication Date:
2019-02-16T05:09:59Z
AUTHORS (9)
ABSTRACT
BackgroundAcute pancreatitis (AP) is associated with a high death rate in dogs, but accurate predictors of early death are still lacking.ObjectivesTo develop a scoring system for prediction of short‐term case fatality in dogs with AP.AnimalsOne hundred sixty‐nine dogs with AP including 138 dogs in the training cohort and 31 dogs in the validation cohort.MethodsMulticenter, retrospective cohort study. Survival analysis was used to assess the associations with short‐term death (within 30 days after admission). Independent predictors of death were identified by a stepwise selection method and used for the score calculation.ResultsDeath rate within 30 days after admission was 33% in the training cohort. Four independent risk factors for short‐term death were identified in the training cohort: presence of systemic inflammatory response syndrome, coagulation disorders, increased creatinine and ionized hypocalcemia. Canine Acute Pancreatitis Severity (CAPS) score was developed to predict short‐term death, integrating these 4 factors in a weighted way. A simplified version of CAPS score (sCAPS) including respiratory rate instead of SIRS was also assessed. The area under the receiver‐operating characteristic curve (AUC) of CAPS and sCAPS scores was 0.92 in the training cohort with an optimal cutoff of 11 (sensitivity, 89%; specificity, 90%) and 6 (sensitivity, 96%; specificity, 77%), respectively. CAPS and sCAPS score were validated in the validation cohort with respective AUC of 0.91 and 0.96.Conclusions and Clinical ImportanceWe propose 2 scoring systems that allow early and accurate prediction of short‐term death in dogs with AP.
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