Development and validation of a Chronic Pancreatitis Prognosis Score (COPPS) in two independent cohorts
09 May 2017 (online)
The clinical course of chronic pancreatitis is unpredictable and so far, no prediction model to assess the dynamic disease severity has been established.
Patients and Methods:
We prospectively recruited 111 patients with chronic pancreatitis. Clinical, laboratory and imaging data were correlated to number of readmissions and in-hospital days over the next 12 months, and parameters showing best correlation were used for development of a three stage chronic pancreatitis prognosis score (COPPS). The predictive value was validated in 129 independent subjects identified from two prospective databases.
The median number of hospital admissions was 2.3 [95%CI 1.8 – 2.8] and 16.5 for hospital days [95%CI 12.7 – 20.2] for the development cohort and 10.9 for the validation cohort [95% CI 7.5 – 14.3] (P =0.08). Based on bivariate correlations, pain (numeric rating scale), HbA1c, CRP, BMI and thrombocyte count were used for development of COPPS. Median COPPS was 9.1 points (range 5 to 14) and it successfully discriminated stages of disease severity (low to high): A (5 – 6 points), B (7 – 9) and C (10 – 15). Pearson correlation showed significant correlation to hospital admissions (0.52; P<0.01) and number of hospital days (0.40; P<0.01) in the development cohort. This correlation was validated in the validation set (0.44; P < 0.01). There was no correlation with the Cambridge classification.
We developed and validated a novel, easy to use dynamic multivariate score similar to the Child-Pugh-Score for cirrhosis. COPPS allowed objective monitoring of chronic pancreatitis regarding readmission to hospital as well as length of hospital stay.