Introduction/Aim:
We have recently developed an easy to use dynamic multivariate scoring system for
patients with chronic pancreatitis using BMI, pain, CRP, platelet count and HbA1c.
COPPS allowed objective monitoring of disease severity, determining risk for readmission
to hospital and potential length of hospital stay in a prospective development cohort
and retrospective validation cohort, both recruited in Northern Germany and Denmark
(Beyer G et al. Gastroenterology. 2017). The predictive performance of COPPS in a
more diverse population of chronic pancreatitis patients is unknown. Here we aim to
prospectively validate COPPS in an international cohort of chronic pancreatitis patients.
Methods:
We prospectively recruited 252 patients between 04/2016 and 01/2018 with chronic pancreatitis
from 8 centers in Europe, Japan, India and North America. At baseline COPPS, demographics
and etiological factors were recorded and patients were follow-up for one year. The
primary end-point was number of readmissions to hospital and the combined length of
all hospital stays during the follow-up period. The study was approved by IRB of all
participating centers.
Results:
Of the 252 included patients 220 (26.4% female, median age at diagnosis 50 years,
alcohol and idiopathic most common etiology) had full data available for analysis.
Mean COPPS was 8.06 points (SD ± 1.84), with 46, 122 and 52 patients in the respective
COPPS category A, B, C. Mean number of hospital admission during follow-up was 1.07
(SD ± 1.60) with a mean number of 9.63 days (SD ± 23.35) spent in hospital. COPPS
showed good correlation with both primary endpoints (p < 0.01) for parametric and
non-parametric testing. Patients with high COPPS category (B, C) had a significantly
higher risk for readmission (p < 0.05). Regular bootstrapping with 1000 repeats excluded
significant bias.
Conclusion:
COPPS reliably predicts risk for readmission in a large, prospective, international
cohort of patients with chronic pancreatitis. This further supports the potential
value of COPPS as a reliable grading tool for severity of chronic pancreatitis warranting
its use in clinical routine and clinical research. Recruitment to this cohort will
continue until a final number of 500 subjects is reached.
