Acute pancreatitis may manifest as mild to severe disease. Severe acute pancreatitis requires management in an intensive care unit, whereas mild acute pancreatitis may only need brief supportive care. Because it is difficult to predict the course of pancreatitis on presentation, various algorithms have been devised to predict the severity of disease. The Harmless Acute Pancreatitis Score (HAPS) has been proposed as an early predictor of severity of illness among the patients presenting with acute pancreatitis. It allows rapid identification of patients with acute pancreatitis who will have a milder course and will not require intensive care unit (ICU) admission. The aim of this study was to validate the HAPS in patients in the United States
Consecutive adults admitted with acute pancreatitis between January 2007 and June 2010 to a tertiary‐care hospital were identified from computerized medical records. The HAPS was calculated based on presence of guarding or rebound tenderness, serum creatinine level, and hematocrit level on presentation. A normal HAPS meant the patient had no guarding or rebound tenderness on presentation, a serum creatinine < 2 mg/dL and a normal hematocrit (below 43% in men and below 39.6% in women). Patients with severe pancreatitis were as defined as those requiring ICU stay or who died during the hospitalization.
Of the 303 patients in the study, 122 patients had normal HAPS. There were a total of 52 patients who developed severe pancreatitis. A normal HAPS was highly correlated with a nonsevere course of the disease (P < 0.0002). The score correctly identified a harmless course in 114 of 122 patients. Using the HAPS, overall specificity for predicting mild disease was 84.6%, with a positive predictive value of 93.4%. The average length of stay in the hospital was 4.3 days with a normal HAPS versus 6.2 days for an abnormal HAPS (P = 0.002). Age, race, and sex did not affect the accuracy of the HAPS.
We validated the HAPS in a Midwestern tertiary‐care hospital as a predictor for nonsevere disease. It proved to be highly accurate in identifying patients who would not require intensive care management. The score is simple and easy to calculate. Use of the HAPS could help physicians more effectively triage patients presenting with acute pancreatitis and may identify patients requiring supportive care rather than full admission. Thus, it could positively impact the hospital by lowering its costs.
R. Parekh ‐ none; A. Zalawadia ‐ none; N. Ambulgekar ‐ none; A. Dave ‐ none; G. Buran ‐ none
To cite this abstract:Parekh R, Zalawadia A, Dave A, Ambulgekar N, Buran G. Harmless Acute Pancreatitis Score (Haps) As an Initial Predictor of Nonsevere Disease in Acute Pancreatitis. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 91. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/harmless-acute-pancreatitis-score-haps-as-an-initial-predictor-of-nonsevere-disease-in-acute-pancreatitis/. Accessed April 5, 2020.