
==== Front
Medicine (Baltimore)
Medicine (Baltimore)
MD
Medicine
0025-7974
1536-5964
Lippincott Williams & Wilkins Hagerstown, MD

39312379
MD-D-24-03052
00080
10.1097/MD.0000000000039738
3
4500
Research Article
Observational Study
Evaluating the prognostic performance of the novel ERAP score in Vietnamese acute pancreatitis patients
https://orcid.org/0009-0002-3955-4097
Phan Nhan Trung MD, MSc abphantrungnhan.27071995@gmail.com

Vo Dung My Thi MD, PhD duythong@ump.edu.vn
a
https://orcid.org/0000-0002-8233-8202
Huynh Tien Manh MD, MSc abc*
Ho Phat Tan MD, MSc bsphatbvcr@gmail.com
a
Phuoc Ma Nguyen MD, MSc a
https://orcid.org/0000-0002-4151-7861
Vo Thong Duy MD, PhD bc
a Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
b Department of Gastroenterology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
c Department of Gastroenterology, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
* Correspondence: Tien Manh Huynh, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; Department of Gastroenterology, University Medical Center Ho Chi Minh City, Ho Cho Minh City Vietnam (emails: tien.hm@umc.edu.vn, tienhuynh@ump.edu.vn).
20 9 2024
20 9 2024
103 38 e3973826 3 2024
23 8 2024
27 8 2024
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

Early recognition of severe acute pancreatitis (AP) is crucial for timely intervention. This study aims to evaluate the prognostic accuracy of the Emergency Room Assessment of AP (ERAP) score and compare it with the Bedside Index for Severity in AP (BISAP) score in predicting severe AP, mortality, and persistent multiple organ failure (MOF) in Vietnamese patients. This prospective cohort study included AP patients admitted to Cho Ray Hospital between August 2021 and May 2022. Patient data, including demographics, clinical presentations, and laboratory results, were collected upon admission. The ERAP and BISAP scores were calculated from these admission data. The prognostic accuracy for severe AP, mortality, and persistent MOF was assessed via the area under the receiver-operating characteristic curve (AUC). Among 167 AP patients (mean age 41.5 ± 12.0 years), hypertriglyceridemia (34.7%) and alcohol (22.2%) were the most prevalent etiologies. Severe AP accounted for 33.5% of the patients. Mortality rates were higher in persistent MOF patients (42.9%) than in persistent single-organ failure patients (3.6%), with a P value <.001. The ERAP score had AUCs for predicting severe AP, mortality, and persistent MOF of 0.899, 0.817, and 0.867, respectively, with an optimal cutoff of ≥2. The ERAP score had a better prognostic value than the BISAP score in predicting severe AP (AUC: 0.899 vs 0.820; P = .0072) and persistent MOF (AUC: 0.867 vs 0.785; P = .0193) but had a similar prognostic value for mortality (AUC: 0.817 vs 0.728; P = .0628). The ERAP score has strong predictive value for severe AP and persistent MOF, surpassing the BISAP score in these categories while maintaining similar accuracy for mortality prediction in the Vietnamese population. The ERAP score can be a valuable tool for the early identification of high-risk AP patients, enabling timely and appropriate clinical interventions.

acute pancreatitis
ERAP score
mortality
organ failure
prognostic score
Vietnam
OPEN-ACCESSTRUE
SDCT
==== Body
pmc1. Introduction

Acute pancreatitis (AP) is a common cause of hospital admissions, with a global incidence that has been consistently rising at a rate of 3.07% from 1961 to 2016.[1–3] The management of AP is primarily supportive and tailored to the individual patient’s clinical context, as the disease course can vary widely and may unpredictably progress from mild to severe forms.[2,4] Severe AP accounts for approximately 30% of the mortality rate, with the majority of deaths in AP patients resulting from persistent multiple organ failure (MOF).[5,6] Given these circumstances, it’s crucial to identify patients at high risk for severe AP and death early on to ensure timely and appropriate care. Several scoring systems have been developed to assess patients with AP immediately in a clinical setting to aid in this. These include the Ranson score, the Acute Physiology and Chronic Health Examination II system, and the Glasgow-Imrie score. These tools comprehensively evaluate the patient’s condition, helping predict disease severity and potential complications.[1,7] Despite the robust predictive value of conventional AP scoring systems, their complexity due to multiple parameters and the possible requirement of up to 2 days for a complete evaluation can pose challenges. To address this, the Bedside Index for Severity in Acute Pancreatitis (BISAP) was introduced in 2008 as a reliable method for the early detection of hospital mortality in AP patients.[8,9] This score was recommended for severity assessment in several clinical guidelines.[10,11] It is preferred over many traditional scores as it requires only 5 parameters and facilitates patient assessment within the initial 24 hours of admission. However, the incorporation of the Systemic Inflammatory Response Syndrome, which contains 4 variables, into the BISAP score results in an 8-variable system, making it more complicated to calculate. The prompt recognition of patients with high-risk AP upon their arrival for enhanced sorting in the emergency unit has become an urgent requirement. Recognizing the need for prompt identification of high-risk AP patients upon their arrival for enhanced sorting in the emergency unit, a cohort study of 203 patients in Germany developed the Emergency Room Assessment of Acute Pancreatitis (ERAP) score in 2021. This novel scoring system consists of only 4 variables: respiratory rate (RR) ≥22, Glasgow coma score (GCS) <15, Blood urea nitrogen (BUN) ≥25 mg/dL, and C-reactive protein (CRP) >150 mg/L. This system facilitates the rapid assessment of AP patients at admission with good predictive value for mortality.[12] Given the limited data on the prognostic value of the ERAP score in Asian populations, particularly in Vietnam, this study aimed to assess the effectiveness of the ERAP score in predicting severe AP, mortality, and persistent MOF. Additionally, we aimed to compare the predictive accuracy of the ERAP score with that of the established BISAP score in a Vietnamese cohort.

2. Methods

2.1. Settings and study design

We performed a cohort study that was carried out prospectively (from August 2021 to May 2022), including patients with AP who were hospitalized at Cho Ray Hospital. The study recruited all individuals who were 18 years of age or older and identified with AP at Cho Ray Hospital. Several exclusion criteria were applied, including time from symptom onset to hospital admission exceeding 72 hours, intubation or vasopressor therapy prior to admission, pregnancy, presence of autoimmune disease or severe medical conditions prior to the onset of AP (such as NYHA IV heart failure, decompensated cirrhosis, cancer, end-stage renal failure, etc), Severe Acute Respiratory Syndrome Coronavirus 2 infection, history of chronic pancreatitis, or having been diagnosed with AP 4 or more times.

2.2. Data collection

Upon admission to the Emergency Department, data were gathered from patients diagnosed with AP. This included demographic information, symptoms, vital signs, physical examination findings, level of mental status based on the GCS, laboratory test results, contrast-enhanced abdominal computed tomography (CECT) imaging studies, and chest radiographs. The ERAP and BISAP scores were computed utilizing data procured at the time of admission. Endpoints, including severity based on the revised Atlanta Classification, mortality during hospitalization, transient organ failure, persistent single-organ failure, persistent MOF, and length of hospital stay, were analyzed as outcome parameters.

Laboratory data were obtained via the machinery system at Cho Ray Hospital.

2.3. Criteria and definitions

The diagnosis of AP required at least 2 of the following 3 criteria: abdominal pain suggestive of AP, serum lipase or amylase levels at least threefold higher than the upper normal limit, and AP-specific findings on CECT scans.[13]

The ERAP score is calculated on a scale of 0 to 4, with each of the subsequent criteria contributing a singular unit toward the total score: RR of 22 breaths per minute or greater, altered mental status with a GCS score of <15, a BUN measurement that equals or exceeds 25 mg/dL, and CRP level >150 mg/L.[12]

The BISAP score is comprised of 5 distinct variables, each of which contributes a single unit to the overall score, based on the fulfillment of the respective criteria: a BUN measurement that surpasses 25 md/dL, coupled with a compromised mental state as indicated by a GCS score that is below 15, a Systemic Inflammatory Response Syndrome score that equals or exceeds 2, an individual exceeding 60 years of age, and the detection of pleural effusion as evidenced by chest radiograph or CECT scans.[14] The scores were obtained at admission and, if necessary, completed within 48 hours.

The severity of AP is categorized in accordance with the revised Atlanta Classification.[13] Mild AP is typified by the nonexistence of organ failure and the lack of local or systemic complications. Moderately severe AP is distinguished by the occurrence of transient organ failure (with a duration of <48 hours) and/or local or systemic complications. Mild AP and moderately severe AP fall under the category of non-severe AP. Severe AP is identified by the persistence of organ failure that extends beyond 48 hours. The determination of organ failure is made according to the modified Marshall scoring system. This system stipulates that a score of 2 or higher in any 1 of the 3 organ systems (namely, respiratory, cardiovascular, and renal) is indicative of organ failure. Organ failure that endures for a duration <48 hours is categorized as transient, whereas if the organ failure extends beyond a period of 48 hours, it is classified as persistent.[13] Persistent MOF is characterized by the enduring malfunction in no fewer than 2 organ systems.

2.4. Statistical analysis

The analysis of the data was conducted utilizing STATA 14.2 software. Variables of a qualitative nature were expressed as frequencies and percentages. Conversely, quantitative variables that followed a normal distribution were articulated as the mean plus or minus the standard deviation. Quantitative variables that did not follow a normal distribution were expressed as the median and interquartile ranges. The χ2 test or Fisher exact test was employed to compare 2 categorical groups. The efficacy of the ERAP and BISAP scores was evaluated by the area under the receiver-operating characteristic curve (AUC), with the derived values being interpreted by Supplementary Table, Supplemental Digital Content 1, http://links.lww.com/MD/N584.[15] Cutoff values were determined based on optimal Youden indexes, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR), and negative LR of the ERAP score were calculated. Positive LR values >5 but <10 or negative LR values <0.2 but >0.1 were considered to have a moderate impact on posttest probability.[16] The efficacy of the ERAP and BISAP scores, as determined by the AUC, was contrasted utilizing the DeLong method.[17] The variations in the rates of severity, mortality, and persistent MOF in relation to an increase in the ERAP score were assessed using the Cochran–Armitage trend test. A P value that is <.05 was deemed to hold statistical significance.

2.5. Ethics statement

All participants provided written informed consent, adhering to the ethical guidelines of the Declaration of Helsinki. The study received approval from the Institutional Review Board of the University of Medicine and Pharmacy at Ho Chi Minh City, as evidenced by the IRB number: 526/HDDD-DHYD.

3. Results

3.1. Patient characteristics

From August 2021 to May 2022, our study included 167 clinically diagnosed AP patients (Fig. 1). The participant demographics and medical characteristics are summarized in Table 1. The mean age was 41.5 ± 12.0 years, with a male-to-female ratio of 2.8:1. Hypertriglyceridemia was the predominant cause (34.7%), followed by alcohol consumption (22.2%). The mean body mass index was 25.2 kg/m2, and 43.7% of the participants had diabetes mellitus. Moderately severe AP was diagnosed in 61.1% of patients, whereas 33.5% had severe AP with persistent organ failure. Persistent MOF occurred in 16.8% of the patients. The overall mortality rate was 7.8%, with all deaths (23.2%) occurring in severe AP patients. The median hospitalization duration was 7 days for all participants. The median ERAP score and BISAP score were both 1.

Table 1 Demographic and clinical characteristics.

Variables	Findings	
Age mean ± SD	41.5 ± 12.0	
Male/female	2.8:1	
Etiology n (%)
 Biliary
 Alcoholic
 Hypertriglyceridemia
 Alcoholic and hypertriglyceridemia
 Unknown causes	18 (10.8)
37 (22.2)
58 (34.7)
26 (15.6)
28 (16.7)	
BMI (kg/m2) mean ± SD	25.2 ± 3.9	
Co-existing diseases n (%)
 Diabetes mellitus
 Hypertension
 Heart failure
 Chronic obstructive pulmonary disease	73 (43.7)
30 (18.0)
0 (0)
1 (0.6)	
Severity n (%)
 Mild
 Moderately severe
 Severe	9 (5.4)
102 (61.1)
56 (33.5)	
Persistent organ failure n (%)
Persistent single-organ failure
Persistent MOF	56 (33.5)
28 (16.8)
28 (16.8)	
Mortality n (%)
Mortality in severe AP
Mortality in persistent single-organ failure
Mortality in persistent MOF	13 (7.8)
13/56 (23.2)
1/28 (3.6)*
12/28 (42.9)*	
Admission to the ICU department n (%)	31 (18.6)	
Hospital stay n (%)	7 (5–10)	
Variables of the ERAP score n (%)
 Altered mental status (GCS <15)
 RR ≥22 per minute
 BUN level ≥25 mg/dL
 CRP >150 mg/dL	16 (9.6)
61 (36.5)
42 (25.2)
115 (68.9)	
ERAP score	1 (1–2)	
BISAP score	1 (1–2)	
Data are presented as mean ± SD, number (%) or median (interquartile range).

AP = acute pancreatitis, BMI = body mass index, BUN = blood urea nitrogen, CRP = C-reactive protein, ERAP = Emergency Room Assessment of Acute Pancreatitis, GCS = Glasgow Coma Score, ICU = intensive care unit, MOF = multiple organ failure, RR = respiratory rate.

* Mortality in persistent MOF was significantly higher than single-organ failure with P value < .001 (χ2 test).

Figure 1. Flowchart of the study. AP = acute pancreatitis, BISAP = Bedside Index for Severity in Acute Pancreatitis, BUN = blood urea nitrogen, CRP = C-reactive protein, ERAP = Emergency Room Assessment of Acute Pancreatitis, GCS = Glasgow coma score.

3.2. Characteristics of the ERAP score

Among the 4 components of the ERAP score, our study revealed that CRP levels exceeding 150 mg/L were the most prevalent (68.9%), followed by an RR of 22 breaths per minute or higher (36.5%). Altered mental status was observed in only 9.6% of patients. A substantial portion of patients had an ERAP score of 1 (34.7%), with smaller percentages of 15.6% and 3.6% for ERAP scores of 3 and 4, respectively. A noteworthy trend emerged as the ERAP score increased, correlating with a significant increase in severe AP, mortality, and persistent MOF (Table 2). We employed the Youden index to identify the most discriminative cutoff points for both the ERAP and BISAP scores to optimize the prediction of severe AP, mortality, and persistent MOF. An ERAP score of 2 emerged as the optimal cutoff, demonstrating high sensitivity, specificity, PPV, and NPV for all 3 outcomes. Similarly, utilizing the Youden index, the optimal cutoff points for the BISAP score were identified as 2, 3, and 2 for predicting severe AP, mortality, and MOF, respectively. The sensitivity, specificity, PPV, and NPV of both the ERAP and BISAP scores based on these optimal cutoffs are presented in Table 3.

Table 2 Correlation of severe acute pancreatitis, mortality, and persistent multiple organ failure with ERAP score.

ERAP score	Number of patients	Severe AP	Mortality	Persistent MOF	
0	40 (24.0)	0 (0.0)	0 (0.0)	0 (0.0)	
1	58 (34.7)	7 (12.1)	1 (1.7)	3 (5.2)	
2	37 (22.1)	21 (56.8)	5 (13.5)	7 (18.9)	
3	26 (15.6)	23 (88.5)	5 (19.2)	13 (50.0)	
4	6 (3.6)	5 (83.3)	2 (33.3)	5 (83.3)	
Data are presented as numbers (%). Cochran–Armitage trend test P value for severe AP, mortality, and persistent MOF were <.01, <.01, and <.01, respectively.

AP = acute pancreatitis, ERAP = Emergency Room Assessment of Acute Pancreatitis, MOF = multiple organ failure.

Table 3 Diagnostic performance of ERAP and BISAP scores at established cutoff points in predicting severe acute pancreatitis, mortality, and persistent multiple organ failure.

	Severe AP	Mortality	Persistent MOF	
ERAP	
 Cutoff	2	2	2	
 Sensitivity	87.5	92.3	89.3	
 Specificity	82.0	63.0	68.4	
 PPV	71.0	17.4	36.2	
 NPV	92.2	99.0	96.9	
BISAP	
 Cutoff	2	3	2	
 Sensitivity	76.8	53.9	78.6	
 Specificity	73.9	83.1	64.0	
 PPV	59.7	21.2	30.6	
 NPV	86.3	95.5	93.7	
Data are presented as percent (%).

AP = acute pancreatitis, BISAP = Bedside Index for Severity in Acute Pancreatitis, ERAP = Emergency Room Assessment of Acute Pancreatitis, MOF = multiple organ failure, NPV = negative predictive value, PPV = positive predictive value.

3.3. Comparative analysis of ERAP and BISAP scores for predicting severe AP, mortality, and persistent MOF

The AUC for the ERAP score in predicting severe AP was 0.899 (95% confidence interval [CI], 0.854–0.944), whereas the AUC for the BISAP score was 0.820 (95% CI, 0.756–0.884). For mortality prediction, the AUC for the ERAP score was 0.817 (95% CI, 0.726–0.907), and for the BISAP score, it was 0.728 (95% CI, 0.588–0.867). In predicting persistent MOF, the AUC for the ERAP score was 0.867 (95% CI, 0.802–0.932), and for the BISAP score, it was 0.785 (95% CI, 0.699–0.871), as illustrated in Figure 2. A comparison of the ERAP and BISAP scores for the prediction of severe AP and persistent MOF revealed that the ERAP score was significantly more accurate (P = .0072 and P = .0193, respectively). However, there was no statistically discernible difference between the 2 scores in predicting mortality (P = .0628). The optimal cutoff points for the ERAP and BISAP scores were used to determine positive and negative LRs for predicting severe AP, mortality, and persistent MOF, as presented in Table 4.

Table 4 Positive and negative likelihood ratios of the ERAP and the BISAP scores in predicting severe acute pancreatitis, mortality, and persistent multiple organ failure.

	The ERAP score	The BISAP score	
Severe AP	Mortality	Persistent MOF	Severe AP	Mortality	Persistent MOF	
Positive LR	4.86	2.49	2.82	2.94	3.19	2.18	
Negative LR	0.15	0.12	0.16	0.31	0.56	0.33	
AP = acute pancreatitis, BISAP = Bedside Index for Severity in Acute Pancreatitis, ERAP = Emergency Room Assessment of Acute Pancreatitis, LR = likelihood ratio, MOF = multiple organ failure.

Figure 2. Comparative analysis of the AUC for the ERAP and BISAP scores in predicting adverse outcomes in AP patients. (A) AUC comparison between ERAP and BISAP scores for the prediction of severe AP. (B) AUC comparison between ERAP and BISAP scores for the prediction of mortality. (C) AUC comparison between ERAP and BISAP scores for the prediction of persistent MOF. AP = acute pancreatitis, AUC = area under the receiver-operating characteristic curve, BISAP = Bedside Index for Severity in Acute Pancreatitis, ERAP = Emergency Room Assessment of Acute Pancreatitis, MOF = multiple organ failure, ROC = receiver-operating characteristic.

4. Discussion

This study represents the first assessment of the prognostic performance of the ERAP score in a Vietnamese patient population with AP. Our findings demonstrate that the ERAP score has robust discriminatory ability for severe AP, mortality, and persistent MOF, surpassing the BISAP score in predicting severe AP and persistent MOF.

Our study, which was conducted at Cho Ray Hospital, a tertiary healthcare institution, revealed that 33.5% of patients experienced severe AP, and 23.2% of those with severe AP died. These findings underscore the need for a straightforward scoring system to anticipate adverse outcomes in AP patients. The ERAP score had an AUC of 0.899 for predicting severe AP, which was significantly greater than the AUC of 0.689 reported by Rasch et al,[12] possibly due to differences in patient populations and the inclusion criteria for severe AP. Our study revealed that the ERAP score had an AUC of 0.817, which was close to the AUC of 0.887 reported by Rasch et al.[12] These findings suggest that the ERAP score is a strong predictor of significant outcomes in AP patients. However, our limited number of deaths (n = 13) means these findings should be interpreted cautiously. We identified persistent MOF as a key determinant of mortality in AP patients, supported by studies such as Machicado et al,[5] who reported a 39.5% mortality rate in patients with 2 to 3 persistent organ failures, and Schepers et al,[18] who reported a 43.4% mortality rate in those with persistent MOF. Our results are consistent with these studies, with a 42.9% mortality rate in patients with persistent MOF, whereas the mortality rate was 3.6% in those with persistent single-organ failure (P < .001). The ERAP score is a dependable tool for predicting persistent MOF, with an AUC of 0.867.

The BISAP score also showed good proficiency in predicting severe AP, with an AUC of 0.820, which is consistent with prior research by Papachristou et al[19] and Gao et al,[14] who reported AUCs of 0.81 and 0.88, respectively. However, the ERAP score surpassed the BISAP score in predicting severe AP and persistent MOF, while both had similar performance predicting mortality. The lower prognostic performance of the BISAP score could be due to its reliance on admission data rather than the most severe values recorded within the initial 24 hours. Additionally, our relatively young patient cohort (mean age of 41.5 years) may have reduced the impact of age >60 years on the BISAP score. Our findings suggest that the ERAP score, which incorporates 2 clinical and 2 laboratory variables, is a valuable instrument for evaluating AP at the time of admission and offers a simpler alternative to previous scoring systems.

The ERAP score exhibited high sensitivity but low specificity in predicting severe AP, mortality, and persistent MOF, resulting in a high NPV and low PPV. This means that patients with an ERAP score below the cutoff are less likely to experience adverse outcomes, but those with a score of 2 or greater cannot be definitively predicted to have unfavorable outcomes. We also computed LRs, which showed that both scores have limited influence on identifying high-risk patients. However, the negative LRs of the ERAP score in predicting severe AP, mortality, and persistent MOF were all <0.2, indicating its reliability in identifying low-risk patients.

Our study is the first prospective study in Vietnam to validate the clinical value of the ERAP score. Owing to its high sensitivity and rapid assessment capability, the ERAP score allows for early identification of high-risk AP patients, facilitating timely and appropriate clinical interventions. This could reduce mortality rates and improve patient outcomes. In our cohort, 58.7% of patients had an ERAP score of <2, suggesting that using this score could reduce the burden of patient monitoring in a tertiary center.

Despite its strengths, our study has several limitations. It was conducted in a single tertiary center, which may limit the generalizability of our conclusions. Additionally, a portion of our patients were referred from other medical facilities, which may have influenced the clinical and laboratory variables. Furthermore, our investigation focused on in-hospital outcomes without assessing long-term post-discharge outcomes. Future multicenter studies with extended follow-up periods are needed to validate further the predictive accuracy and clinical utility of the ERAP score.

In conclusion, the ERAP score is a straightforward and reliable tool for evaluating AP patients upon admission, accurately predicting severe AP, mortality, and persistent MOF. Its implementation in clinical practice can enhance early risk stratification and improve patient outcomes. This study supports the broader use of the ERAP score in diverse clinical settings, particularly in populations similar to the Vietnamese cohort studied here.

Acknowledgments

The authors would like to sincerely thank the Department of Gastroenterology at Cho Ray Hospital and the Faculty of Medicine at the University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam. Additionally, the authors are grateful to Dr Thinh Ong from the Mathematical Modelling group at the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam, for providing valuable statistical consultation.

Author contributions

Conceptualization: Nhan Trung Phan, Dung My Thi Vo.

Data curation: Nhan Trung Phan, Dung My Thi Vo, Nguyen Phuoc Ma.

Formal analysis: Nhan Trung Phan, Dung My Thi Vo, Nguyen Phuoc Ma.

Funding acquisition: Nhan Trung Phan, Dung My Thi Vo, Nguyen Phuoc Ma, Thong Duy Vo.

Investigation: Nhan Trung Phan, Dung My Thi Vo, Phat Tan Ho.

Methodology: Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh, Nguyen Phuoc Ma.

Project administration: Nhan Trung Phan, Dung My Thi Vo.

Resources: Nhan Trung Phan, Dung My Thi Vo, Phat Tan Ho.

Software: Nhan Trung Phan, Dung My Thi Vo.

Supervision: Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh, Phat Tan Ho, Thong Duy Vo.

Validation: Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh, Thong Duy Vo.

Visualization: Nhan Trung Phan, Dung My Thi Vo.

Writing—original draft: Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh.

Writing—review & editing: Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh, Phat Tan Ho, Nguyen Phuoc Ma, Thong Duy Vo.

Supplementary Material

Abbreviations:

AP acute pancreatitis

AUC area under the receiver-operating characteristic curve

BISAP Bedside Index for Severity in Acute Pancreatitis

BUN blood urea nitrogen

CECT contrast-enhanced abdominal computed tomography

CRP C-reactive protein

ERAP Emergency Room Assessment of Acute Pancreatitis

GCS Glasgow coma score

MOF multiple organ failure

NPV negative predictive value

PPV positive predictive value

ROC receiver-operating characteristic

RR respiratory rate

The authors have no funding and conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Supplemental Digital Content is available for this article.

How to cite this article: Phan NT, Vo DMT, Huynh TM, Ho PT, Phuoc Ma N, Vo TD. Evaluating the prognostic performance of the novel ERAP score in Vietnamese acute pancreatitis patients. Medicine 2024;103:38(e39738).

NTP and DMTV contributed equally to this work.
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