The acute patient physiologic and laboratory evaluation score: application in dogs with acute pancreatitis

다국어 초록 (Multilingual Abstract)

The objectives of this retrospective cohort study were to investigate the Acute Patient Physiologic and Laboratory Evaluation (APPLE) score and its components as prognostic markers in dogs with acute pancreatitis. Forty-seven dogs were diagnosed with acute pancreatitis based on satisfying two criteria: the presence of two acute clinical signs (vomiting, anorexia, abdominal pain, or lethargy) and confirmation via specific canine pancreatic lipase (cPL) testing. cPL concentration within the intermediate range supported by compatible ultrasonographic evidence. The dogs were categorized into survival and non-survival groups. The APPLE score components (mentation, respiratory rate, fluid score, SpO₂, WBC, creatinine, albumin, total bilirubin, and lactate) were assessed within 24 hours of admission. Statistical comparisons between the groups showed that the non-surviving dogs had significantly higher APPLE scores (39.36 ± 4.41) compared to the survivors (25.67 ± 9.63, p < 0.01). The predictive ability of the APPLE score for distinguishing the survival group from the non-survival group was excellent, with an Area Under the Curve (AUC) of 0.900. Using the optimal cut-off value, a sensitivity of 1.000 (100.0%) and a specificity of 0.750 (75.0%) were achieved. There were also differences in mentation score, fluid score, SpO₂, creatinine, lactate, and cPL levels between the two groups, indicating poorer prognoses in the non-survivor group. In conclusion, the APPLE score serves as a valuable tool for predicting outcomes in dogs suffering from acute pancreatitis. Its use can help clinicians identify patients at risk, enhance risk assessment, inform treatment decisions, and improve communication with dog owners regarding prognosis.