Validation of AAST EGS grade for acute pancreatitis

Moustafa Younis, Matthew Hernandez, Mohamed Ray-Zack, Nadeem N. Haddad, Asad Choudhry, Pooja Reddy, Martin D. Zielinski

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5 Scopus citations

Abstract

Background The AAST recently developed an emergency general surgery (EGS) disease grading system to measure anatomic severity. We aimed to validate this grading system for acute pancreatitis and compare cross sectional imaging-based AAST EGS grade and compare with several clinical prediction models. We hypothesize that increased AAST EGS grade would be associated with important physiological and clinical outcomes and is comparable to other severity grading methods. Methods Single institution retrospective review of adult patients admitted with acute pancreatitis during 10/2014–1/2016 was performed. Patients without imaging were excluded. Imaging, operative, and pathological AAST grades were assigned by two reviewers. Summary and univariate analyses were performed. AUROC analysis was performed comparing AAST EGS grade with other severity scoring systems. Results There were 297 patients with a mean (±SD) age of 55 ± 17 years; 60% were male. Gallstone pancreatitis was the most common etiology (28%). The overall complication, mortality, and ICU admission rates were 51, 1.3, and 25%, respectively. The AAST EGS imaging grade was comparable to other severity scoring systems that required multifactorial data for readmission, mortality, and length of stay. Conclusions The AAST EGS grade for acute pancreatitis demonstrates initial validity; patients with increasing AAST EGS grade demonstrated longer hospital and ICU stays, and increased rates of readmission. AAST EGS grades assigned using cross sectional imaging findings were comparable to other severity scoring systems. Further studies should determine the generalizability of the AAST system. Level of Evidence: IV Study Type: Single institutional retrospective review

Original languageEnglish (US)
Pages (from-to)430-437
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume22
Issue number3
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

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Keywords

  • AAST
  • Acute pancreatitis
  • Disease
  • Grading
  • Severity

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Younis, M., Hernandez, M., Ray-Zack, M., Haddad, N. N., Choudhry, A., Reddy, P., & Zielinski, M. D. (2018). Validation of AAST EGS grade for acute pancreatitis. Journal of Gastrointestinal Surgery, 22(3), 430-437. https://doi.org/10.1007/s11605-017-3662-0