The key to effective treatment for acute necrotizing pancreatitis (ANP) is the accurate identification of patients at highest risk of mortality, according to an award-winning poster presented by Hassan Ali, MD, at the American College of Gastroenterology Postgraduate Course and Scientific Meeting in Charlotte, North Carolina, on October 23.

“Mortality in Acute Necrotizing Pancreatitis at Baseline (MANP)-B Scoring for the Inpatient Mortality of Acute Necrotizing Pancreatitis” received a Presidential Poster Award in the Biliary/Pancreas category.

Dr. Ali is a resident in internal medicine at East Carolina University in Greenville, North Carolina. He and colleagues noted in the poster that early identification of patients at high risk of mortality from ANP is essential in determining which patients with ANP require aggressive treatment measures.

The investigators conducted a retrospective analysis of 22,980 patients with acute necrotizing pancreatitis (ANP) using the National Inpatient Sample (NIS) in the validation cohort and derived the acute necrotizing pancreatitis at baseline (MANP)-B scoring system using multivariable cox regression analysis and validated using receiver operating characteristic curves in a validation cohort.

The MANP-B score includes 6 variables: age ≥ 60 years; peripheral vascular disease; chronic kidney disease or ESRD; chronic liver disease; disorders of coagulation; and fluid or electrolyte imbalance. Age and fluid/electrolyte imbalance were allotted 2 points, with all other variables allotted 1 point; the scoring system yields a total maximum score of 8 points.

Based on the calculated highest sensitivity and specificity values from the receiver operating characteristic (ROC)curves, the determined cut-off values for predicting ANP inpatient mortality at 30-day periods was 4 points using Liu index (Sensitivity 70.14%, Specificity 75.82%) and 3 points for mortality at 7-day periods was 4 points using Liu index (Sensitivity 69.70%, Specificity 78.60%).

“This system can be used as an objective method for predicting 7- and 30-day all-cause mortality for ANP hospitalizations on admission,” the poster presentation concluded.

—Rebecca Mashaw

Reference:

Ali H, Pamarthy R, Dahiya DS, et al. A0017 - Mortality in Acute Necrotizing Pancreatitis at Baseline (MANP)-B Scoring for the Inpatient Mortality of Acute Necrotizing Pancreatitis. Poster session A. Presented at: ACG 2022 Annual scientific meeting and Postgraduate course. Charlotte, North Carolina. October 23, 2022.