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BISAP, RANSON, lactate and others biomarkers in prediction of severe acute pancreatitis in a European cohort
Author(s) -
ValverdeLópez Francisco,
MatasCobos Ana M,
AlegríaMotte Carlos,
JiménezRosales Rita,
ÚbedaMuñoz Margarita,
RedondoCerezo Eduardo
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13763
Subject(s) - medicine , acute pancreatitis , creatinine , receiver operating characteristic , intensive care unit , pancreatitis , gastroenterology , blood urea nitrogen , area under the curve , cohort , apache ii , prospective cohort study , severity of illness
Background and Aim The study aims to assess and compare the predicting ability of some scores and biomarkers in acute pancreatitis. Methods We prospectively collected data from 269 patients diagnosed of acute pancreatitis, admitted to Virgen de las Nieves University Hospital between June 2010 and June 2012. Blood urea nitrogen (BUN), C‐reactive protein, and creatinine were measured on admission and after 48 h, lactate and bedside index for severity acute pancreatitis (BISAP) only on admission and RANSON within the first 48 h. Definitions from 2012 Atlanta Classification were used. Area under the curve (AUC) was calculated for each scoring system for predicting severe acute pancreatitis (SAP), mortality, and intensive care unit (ICU) admission, obtaining optimal cut‐off values from the receiver operating characteristic curves. Results Eight (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 h, BUN 48 h was the best predictor of SAP (AUC = 0.96 CI: 0.92–0.99); BUN 48 h and BISAP were the best predictors for mortality (AUC = 0.97 CI: 0.95–0.99) and creatinine 48 h 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 C‐reactive protein on admission was only a significant predictor of SAP. Conclusion Bedside index for severity acute pancreatitis 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.