Background and Aims
We sought to derive a risk score, DORM65, of known variables to predict the likelihood
of a positive EUS in patients with idiopathic acute pancreatitis (IAP).
Methods
A retrospective cohort study of 180 patients with IAP was performed across 3 tertiary
care centers between January 2018 and December 2021. Multivariate logistic regression
modeling was performed to predict a positive EUS. Accuracy of the models was assessed
by the area under the receiver-operating characteristic curve (AUROCC).
Results
The diagnostic yield of EUS was 58.9% (95% confidence interval [CI], 51.7-66.1). The
DORM65 scores of 5 predictors present before EUS with the best discrimination were
a delayed EUS (defined as ≥82 days from the last episode of AP), obesity, not having
had a repeated transabdominal US, male sex, and age ≥65 years at the time of EUS.
For those at the lowest risk score group, the positive EUS rate was 13.0% compared
with 100% in those at the highest risk group (relative risk, 7.67; P < .001). A score of 3 or more had a positive predictive value of 86.0% with a sensitivity
of 34.9% and specificity of 91.9%. The model had a high predictive accuracy (AUROCC,
.774; 95% CI, .707-.841). Adding 3 additional predictors (no cholecystectomy, no MRCP,
and a single episode of AP) did not increase the accuracy significantly (AUROCC, .805;
95% CI, .742-.867).
Conclusions
DORM65 is easily calculated and accurately predicts a positive EUS in patients with
IAP. Further validation is needed.
Graphical abstract
Graphical Abstract
Abbreviations:
AP (acute pancreatitis), AUROCC (area under the receiver-operating characteristic curve), aOR (adjusted odds ratio), CI (confidence interval), IAP (idiopathic acute pancreatitis), IRAP (idiopathic recurrent acute pancreatitis), NAFPD (nonalcoholic fatty pancreas disease), OR (odds ratio), TUS (transabdominal US)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: July 15, 2022
Accepted:
July 12,
2022
Received:
April 14,
2022
Footnotes
DISCLOSURE: Dr Kumbhari: Consultant for Fuji, Medtronic, and Boston Scientific; Dr Wallace: Consultant for BSCI, Verily, and Olympus. All other authors disclosed no financial relationships.
Presented at Digestive Disease Week, May 24, 2022, San Diego, CA (Gastroenterology 2022;162:S260-1.
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© 2022 by the American Society for Gastrointestinal Endoscopy
