A severity scoring system for outcome prediction in cats with pancreatitis.

Abstract

In order to develop a clinically applicable severity scoring system in cats with pancreatitis, 41 cats diagnosed with pancreatitis and hospitalized between 2011 and 2013 with their complete medical history were selected for analysis. Clinical signs, physical examination findings, laboratory findings, diagnostic imaging results, complications and concurrent diseases were analyzed to evaluate potential prognostic factors and further establish the severity scoring system. The mortality of cats selected in this study due to pancreatitis was 48.8%. Abnormalities in hemoglobin, albumin, blood urea nitrogen, total bilirubin, phosphorous and blood pressure were significantly associated with disease severity and prognosis and were selected for constructing the system. The abnormal range for each variable was further partitioned into quartiles, which were recorded into categorical variables. The weighting factors were calculated from the odds ratios (OR) between each of the quartiles and the normal range category. The area under curve (AUC) of the six continuous variables system at presentation and after rehydration of the cats was 0.873 and 0.976, respectively. The scores of 41 cats after rehydration ranged from 7 to 36 points. The mean score was 19.7±8, the median 17 points and the mode 32 points. The optimal cut-off point for outcome prediction was 17.5 with a sensitivity of 95.2% and specificity of 95.5%. The mortality was 95% with a score≥18, whereas 4.8 % had a score≤17. The severity scoring system provides a reliable and clinically applicable method to predict disease severity in cats with pancreatitis.