Related Experiment Video
Updated: Feb 28, 2026
Preparing a Mice Model of Severe Acute Pancreatitis via a Combination of Caerulein and Lipopolysaccharide Intraperitoneal Injection
Published on: May 10, 2024
Development and validation of a pancreatic injury mortality score (PIMS) based on 473 consecutive patients treated at
Jake E Krige1, Richard T Spence2, Pradeep H Navsaria2
1Department of Surgery, Groote Schuur Hospital, Observatory, Cape Town, South Africa; University of Cape Town Health Sciences Faculty, Surgical Gastroenterology Unit, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
Insights
A new Pancreatic Injury Mortality Score (PIMS) was developed to predict in-hospital death after major pancreatic trauma. This simple score identifies high-risk patients, aiding clinical decision-making.
Area of Science:
- Trauma surgery
- Surgical outcomes
- Predictive modeling
Background:
- Major pancreatic injuries pose a significant risk of in-hospital mortality.
- Accurate risk stratification is crucial for effective patient management.
Purpose of the Study:
- To develop and validate a novel, organ-specific risk prediction score for in-hospital mortality after major pancreatic trauma.
- To identify key clinical factors associated with mortality in these patients.
Main Methods:
- Utilized data from 473 patients in a prospective database (1990-2015).
- Employed stepwise logistic regression on derivation and validation cohorts to identify predictors of in-hospital death.
- Developed the Pancreatic Injury Mortality Score (PIMS) based on significant variables.
Main Results:
- Five variables (age >55, shock on admission, vascular injury, number of associated injuries, AAST pancreatic injury scale) correlated with mortality.
- The PIMS demonstrated strong discriminative ability (ROC 0.84-0.91) in both derivation and validation cohorts.
- Risk stratification into low, medium, and high groups showed comparable mortality rates within groups.
Conclusions:
- The Pancreatic Injury Mortality Score (PIMS) is a validated, simple, and understandable tool for predicting in-hospital mortality in major pancreatic trauma.
- PIMS enhances clinical risk prediction for complex pancreatic injuries and serves as a survival benchmark.
Background:
This study sought to develop a pancreatic injury mortality score (PIMS) to identify patients at greatest risk of in-hospital mortality after a major pancreatic injury.
Methods:
The study used data from a prospective database of 473 patients treated for pancreatic injuries between January 1990 and December 2015. Two thirds of the patients were assigned to the derivation cohort and one third to the validation cohort. Clinical correlates of in-hospital death were identified and considered in stepwise logistic regression analyses that identified the factors included in the risk index.
Results:
Five variables, age >55, shock on admission, a vascular injury, number of associated injuries and American Association for the Study of Trauma (AAST) pancreatic injury scale correlated with in-hospital death and were used to calculate PIMS. The final score ROC in the derivation dataset was 0.84 (95% CI 0.79-0.89) and in the validation dataset was 0.91 (95% CI 0.84-0.97), which were comparable (p = 0.1). Finally, cut-off scores were used to generate three risk groups and the rate of mortality within the low (PIMS 0-4), medium (PIMS 5-9), and high risk (PIMS 10-20) groups were not significantly different. The scoring system was tested in a validation cohort and showed good calibration and discrimination for in-hospital mortality.
Conclusions:
We have derived and validated the PIMS, a novel organ-specific risk prediction score calculated from five variables for in-hospital mortality following major pancreatic trauma. PIMS is simple, quick and easily understandable, increases clinical risk prediction for patients with complex pancreatic and can be used as a benchmark for survival.
More Related Videos
10:38DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
Published on: February 1, 2020
04:01Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis
Published on: September 8, 2022
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include: