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BISAP, RANSON, lactate and others biomarkers in prediction of severe acute pancreatitis in a European cohort.
J Gastroenterol Hepatol. 2017 Feb 16;:
Authors: Valverde-López F, Matas-Cobos AM, Alegría-Motte C, Jiménez-Rosales R, Úbeda-Muñoz M, Redondo-Cerezo E
Abstract
BACKGROUND AND AIM: Assessing and comparing the predicting ability of some scores and biomarkers in Acute Pancreatitis (AP).
METHODS: We prospectively collected data from 269 patients diagnosed of AP, admitted to Virgen de las Nieves University Hospital between June 2010 and June 2012. Blood urea nitrogen (BUN), C-reactive protein (CRP) and creatinine (Cr) were measured on admission and after 48 hours, lactate and BISAP only on admission and RANSON within the first 48 hours. Definitions from 2012 Atlanta Classification were used. Area Under the Curve (AUC) was calculated for each scoring system for predicting SAP, mortality and ICU admission, obtaining optimal cutoff values from the receiver operating characteristic (ROC) curves.
RESULTS: 8(3%) patients died, 17(6.3%) were classified as SAP, and 10(3.7%) were admitted in ICU. BISAP was the best predictor on admission for SAP, mortality and ICU admission with an AUC of 0.9(95%CI 0.83-0.97); 0.97(95%CI 0.95-0.99) and 0.89(95%CI 0.79-0.99) respectively. After 48 hours BUN48h was the best predictor of SAP (AUC = 0.96 CI:0.92-0.99); BUN48h and BISAP where the best predictors for mortality (AUC = 0.97 CI:0.95-0.99) and Cr48h for ICU admission (AUC = 0.96 CI:0.92-0.99). Lactate showed an AUC of 0.79(CI:0.71-0.88), 0.87(CI:0.78-0.96) and 0.77(CI:0.67-0.87) for SAP, mortality and ICU admission respectively. All parameters were predictors for SAP, mortality and ICU admission, but CRP on admission was only a significant predictor of SAP.
CONCLUSION: BISAP is a good predictive system for SAP, mortality and ICU admission, being useful for triaging patients for ICU management. Lactate could be useful for developing new scores.
PMID: 28207167 [PubMed - as supplied by publisher]