Predictive value of apolipoprotein B and A-I ratio in severe acute pancreatitis

2018 ◽  
Vol 33 (2) ◽  
pp. 548-553 ◽  
Author(s):  
Ji Hye Huh ◽  
Saehyun Jung ◽  
Seung Kook Cho ◽  
Kyong Joo Lee ◽  
Jae Woo Kim
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Apolipoprotein B

scholarly journals THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS

2016 ◽  
Vol 29 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Murilo Gamba BEDUSCHI ◽  
André Luiz Parizi MELLO ◽  
Bruno VON-MÜHLEN ◽  
Orli FRANZON
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Length Of Stay ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
High Specificity ◽  
Daily Practice ◽  
Severe Form ◽  
Inclusion Criteria ◽  
Positive Score

Background: About 20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Several studies suggested methods to identify patients that will progress more severely. However, most studies present problems when used on daily practice. Objective: To assess the efficacy of the PANC 3 score to predict acute pancreatitis severity and its relation to clinical outcome. Methods: Acute pancreatitis patients were assessed as to sex, age, body mass index (BMI), etiology of pancreatitis, intensive care need, length of stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined within the first 24 hours after diagnosis and compared to acute pancreatitis grade of the Revised Atlanta classification. Results: Out of 64 patients diagnosed with acute pancreatitis, 58 met the inclusion criteria. The PANC 3 score was positive in five cases (8.6%), pancreatitis progressed to a severe form in 10 cases (17.2%) and five patients (8.6%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 50%, specificity of 100%, accuracy of 91.4%, positive predictive value of 100% and negative predictive value of 90.6% in prediction of severe acute pancreatitis. Conclusion: The PANC 3 score is useful to assess acute pancreatitis because it is easy and quick to use, has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis.

scholarly journals Comparison of BISAP and Ranson’s score for predicting severe acute pancreatitis and establish the validity of BISAP score

2020 ◽  
Vol 7 (5) ◽  
pp. 1473
Author(s):  
Amulya Aggarwal ◽  
Alok V. Mathur ◽  
Ram K. Verma ◽  
Megha Gupta ◽  
Dheeraj Raj
Keyword(s):  
Acute Pancreatitis ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Treatment Protocol ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Clinical Scoring

Background: Pancreatitis can lead to serious complications with severe morbidity and mortality. So an early, quick and accurate scoring system is necessary to stratify the patients according to their severity so as to enable early initiation of required management and care. Scoring system commonly used have some drawbacks. This study aimed to compare bedside index for severity in acute pancreatitis (BISAP) and Ranson’s score to predict severe acute pancreatitis and establish the validity of a simple and accurate clinical scoring system for stratifying patients.Methods: This is a prospective comparative study on 100 patients diagnosed with acute pancreatitis admitted in department of general surgery. Parameters included in the BISAP and Ranson’s criteria were studied at the time of admission and after 48 hours. Result of these two were compared with that of revised Atlanta classification.Results: As per the BISAP score, the sensitivity and specificity were 95.8 % (95% CI, 76.8-99.8), 94.7 % (95% CI, 86.3-98.3) whereas positive likelihood ratio, negative likelihood ratio 18.21 (95% CI, 6.9-47.44), 0.04 (95% CI, 0.01-0.30) and accuracy was 95 % (95% CI, 88.72%-98.36%). On using Ranson’s score, the sensitivity and specificity were 91.6 (95% CI, 71.5-98.5) and 89.4 (95% CI, 79.8-95) with a positive predictive value 8.71 (95% CI, 4.47-18.96) and negative predictive value of 0.09 (95% CI, 0.02-0.35) and accuracy of 90% (95% CI, 82.38%-95.10%)..Conclusions: BISAP score outperformed Ranson’s score in terms of Sensitivity and specificity of prediction of severe pancreatitis. The authors recommend inclusion of BISAP Scoring system in standard treatment protocol of management of acute pancreatitis.

scholarly journals Macrophage migration inhibitory factor is an early marker of severe acute pancreatitis based on the revised Atlanta classification

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dingcheng Shen ◽  
Caixi Tang ◽  
Shuai Zhu ◽  
Gengwen Huang
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Migration Inhibitory Factor ◽  
Predictive Value ◽  
Macrophage Migration Inhibitory Factor ◽  
Serum Markers ◽  
Apache Ii ◽  
Inhibitory Factor ◽  
Macrophage Migration ◽  
Early Marker

Abstract Background Various serum markers for early identification of severe acute pancreatitis (SAP) have been studied. Serum macrophage migration inhibitory factor (MIF) was reported to be correlated with severity of acute pancreatitis (AP) based on the 1992 Atlanta classification. However, MIF has never been proven to be predictive of disease severity based on the revised Atlanta classification (RAC). The potential predictive value of MIF needs to be further validated. Methods Consecutive patients with AP within 48 h after symptom onset and 10 healthy control volunteers were enrolled prospectively. Serum MIF levels were measured by enzyme-linked immunosorbent assay (ELISA). The predictive value of MIF, clinical scores and other serum markers were determined. Results Among 143 patients with AP, there were 52 (36.4%), 65 (45.5%) and 26 (18.1%) with mild, moderate and severe disease based on the RAC respectively. Compared with healthy volunteers, serum levels of MIF were significantly higher in AP patients, especially those with SAP (P < 0.001). Multivariate regression analysis indicated that increased serum MIF (cut-off 2.30 ng/ml, OR = 3.16, P = 0.008), IL-6 (cut-off 46.8 pg/ml, OR = 1.21, P = 0.043), APACHE II score (cut-off 7.5, OR = 2.57, P = 0.011) and BISAP score (cut-off 1.5, OR = 1.01, P = 0.038) were independent risk factors for predicting SAP (P < 0.05). By using the area under the receiver operating characteristic (ROC) curve (AUC), MIF (AUC 0.950) demonstrated more excellent discriminative power for predicting SAP than APACHE II (AUC 0.899), BISAP (AUC 0.886), and IL-6 (AUC 0.826). Conclusions Serum MIF is a valuable early marker for predicting the severity of AP based on the RAC.

scholarly journals Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)

2019 ◽  
Author(s):  
Lan Nie ◽  
Yi Cheng ◽  
Fei Yao ◽  
Ru Shuo Wu ◽  
Ming Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Early Stage ◽  
Area Under The Curve ◽  
Severity Index ◽  
Local Complications ◽  
Type2 Diabetes ◽  
Clinical Worker ◽  
Mild Acute Pancreatitis

Abstract Background: In recent years,the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing.It is important for Clinical worker to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP.Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients.Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score.Results:There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC),Hospitalization days,Fatty liver,and Local complications between two groups,While no statistical differences in Gender, Age,Serum amylase,Alanine aminotransferase(ALT),Aspertate aminotransferase(AST),Hypertension,Type2 diabetes,and Hyperuricemia. Positive relevance was established between BISAP and TG with r of 0.55. The Area Under the Curve(AUC) of BISAP and MCTSI in predicting the severity of HLAP respectively were0.89、0.78，sensitivity were 73.5%、79.4%, specificity were95.5%、60.2%, positive predictive value(PPV) were 80.6%、33.8%, negative predictive value(NPV) were 93.4%、92.0%.In predictionig local complications,the AUC respectively were 0.73、0.87, sensitivity were 37.5%、90.1%, specificity were 93.2%、78.6%, PPV were 77.4%、72.5%, NPV were 70.6%、93.1%.Conclusion: BISAP score has a meaningful prognostic value for predicting the severity of HLAP and higher AUC than MCTSI.In particular,there are significant association between BISAP and TG.Keywords:Hyperlipidemic acute pancreatitis；Triglycerides;BISAP score；MCTSI score; Severe acute pancreatitis

scholarly journals Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)

2020 ◽  
Author(s):  
Lan Nie ◽  
Yi Cheng ◽  
Fei Yao ◽  
Ru Shuo Wu ◽  
Ming Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Early Stage ◽  
Area Under The Curve ◽  
Severity Index ◽  
Local Complications ◽  
Type2 Diabetes ◽  
Mild Acute Pancreatitis

Abstract Background: In recent years, the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing. It is important for clinicians to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP. Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients. Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score. Results：There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC), Hospitalization days, Fatty liver and Local complications between two groups. However, there are no statistical differences(P>0.05) in Gender, Age,Serum amylase, Alanine aminotransferase(ALT), Aspertate aminotransferase(AST), Hypertension, Type2 diabetes and Hyperuricemia. The Area Under the Curve(AUC) of BISAP and MCTSI in predicting the severity of HLAP respectively were 0.89、0.78, sensitivity were 73.5%、79.4%, specificity were95.5%、60.2%, positive predictive value(PPV) were 80.6%、33.8%, negative predictive value(NPV) were 93.4%、92.0%. Furthermore, the AUC respectively were 0.73、0.87, sensitivity were 37.5%、90.1%, specificity were 93.2%、78.6%, PPV were 77.4%、72.5%, NPV were 70.6%、93.1% in predictionig local complications. Conclusion：Compared to MCTSI score, BISAP score may be a better prognostic scoring system for predicting the severity of HLAP in view of accuracy and easiness. Keywords: Hyperlipidemic acute pancreatitis; Triglycerides; BISAP score; MCTSI score; Severe acute pancreatitis

scholarly journals Red Cell Distribution Width as a Predictor of Severity of Acute Pancreatitis

2019 ◽  
Vol 17 (2) ◽  
pp. 43-46
Author(s):  
Pradip Thapa ◽  
Subodh Gautam ◽  
Hemanta Pun ◽  
Anup Sharma
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
College Teaching ◽  
Red Cell Distribution Width ◽  
P Value ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Medical College

Introduction: Acute pancreatitis (AP) is a disorder featured by local and systemic inflammatory response, which manifests as mild, self-limited disorder to severe and sometimes fatal disease. Red cell distribution width (RDW) is reflective of systemic inflammation and has been shown to be effective at predicting severity. This study was aimed to investigate the association between Red cell distribution width as coefficient of variation (RDW -CV) on admission and severity of acute pancreatitis. Method: This was a hospital based prospective study conducted in the Department of Surgery, Nepalgunj Medical College Teaching Hospital for a period of 2 years from July 2017 to June 2019. The patients with acute pancreatitis were categorized into mild, moderate and severe acute pancreatitis. The value of RDW-CV on admission was correlated with the severity of acute pancreatitis. Results: RDW-CV on admission was significantly correlated with the severity of AP (p value <0.001). Receiver Operating Characterstic (ROC) analysis showed that RDW has very good discriminative power for severe acute pancreatitis [AreaUnder curve (AUC) 0.963, 95% CI, 0.919 to 1.007, p-value <0.001] but not useful to predict mild AP (AUC 0.157, 95% CI, 0.063 to 0.250, p value 0.14) and moderate AP (AUC 0.397, 95% CI, 0.252 to 0.541, p value 0.234). The maximum sensitivity and specificity of detecting severe AP was 95.7% and 91.5% respectively. The positive predictive value (PPV) and negative predictive value (NPV) was 84.6% and 97.7% respectively. Conclusion: RDW-CV width on admission is a predictor of severity in patients with severe acute pancreatitis.

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