Comparative analysis of prognostic scoring systems for cats with suspected pancreatitis (472 cats).
Cridge H, Winser J, Wells J, Bolton T, Lim SY, Kibodeaux A, Michel I, Chow B, Jaffey JA, Prior C, Allerton F, Guess S, Prince R, Mackin A, Wang S · Journal of Veterinary Internal Medicine · 2 March 2026
Composite prognostic scores better predict feline pancreatitis outcomes than individual variables, but low positive predictive values limit clinical utility.
This multi-institutional retrospective study evaluated prognostic scoring systems in 472 cats with suspected pancreatitis to identify factors predicting mortality and prolonged hospitalization (≥5 days). Individual variables assessed included potassium, feline pancreas-specific lipase, total bilirubin, total calcium, and total magnesium. Composite scoring schemes evaluated were APPLEfull, APPLEfast, and modified feline activity index (MFAI). APPLEfast demonstrated superior discriminatory ability for case fatality (AUC 0.695), while MFAI showed greatest concordance with hospitalization length (0.673). Significantly different values between fatal and non-fatal cases were observed for total calcium, APPLEfull, APPLEfast, and MFAI. However, positive predictive values for both mortality and prolonged hospitalization were low, despite high negative predictive values. The findings suggest composite scoring schemes provide greater prognostic utility than individual variables alone, though clinicians should interpret results cautiously when making individual patient decisions.
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