Comparative analysis of BISAP and APACHE II scoring systems in early prediction of severity of acute pancreatitis

Background: Acute pancreatitis is the single most frequent gastrointestinal cause of hospital admissions. Scoring systems have been used since the 1970s for assessment of its severity. This study was aimed to assess the clinical pattern of acute pancreatitis and to compare various predicting systems like Ranson, BISAP and APACHE II in predicting severity, local complications and mortality in acute pancreatitis.Methods: In this prospective study, 91 consecutive cases of acute pancreatitis admitted, between April 2015 to March 2017, were studied. The diagnostic criteria include the presence of at least two of the three features; abdominal pain, serum amylase and lipase levels and findings on imaging studies. Patients were divided into two groups each, BISAP Ranson ≥3 and <3, APACHE II ≥8 and <8, and analyzed statistically.Results: Out of total of 91 patients, 81 were male and 14 were female with mean age was 36.14 years. Commonest aetiological factor was alcoholism in 57.89% followed by gallstones in 23.16%. Serum amylase was raised in 83.26% patients while 95.79% had raised serum lipase levels. 75.79% patients were of MAP while 24.21% patients were of MSAP and SAP. 7.37% patients developed local complications and mortality rate was 6.32%. All the scoring systems were found similar in predicting severity, local complication and mortality, had low sensitivity and high specificity (P value < 0.05).Conclusions: There is no ideal predicting system for acute pancreatitis. These scoring systems can be used to triage patients for better healthcare delivery.

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Comparison of Ranson, APACHE II and APACHE III Scoring Systems in Acute Pancreatitis

Pancreas ◽

10.1097/00006676-200211000-00002 ◽

2002 ◽

Vol 25 (4) ◽

pp. 331-335 ◽

Cited By ~ 40

Author(s):

Constantinos Chatzicostas ◽

Maria Roussomoustakaki ◽

Ioannis G. Vlachonikolis ◽

Georgios Notas ◽

Ioannis Mouzas ◽

...

Keyword(s):

Acute Pancreatitis ◽

Scoring Systems ◽

Apache Ii ◽

Apache Iii

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Early Prediction of the Severity of Acute Pancreatitis Using Radiologic and Clinical Scoring Systems With Classification Tree Analysis

American Journal of Roentgenology ◽

10.2214/ajr.18.19545 ◽

2018 ◽

Vol 211 (5) ◽

pp. 1035-1043 ◽

Cited By ~ 1

Author(s):

Hye Won Choi ◽

Hyun Jeong Park ◽

Seo-Youn Choi ◽

Jae Hyuk Do ◽

Na Young Yoon ◽

...

Keyword(s):

Acute Pancreatitis ◽

Classification Tree ◽

Scoring Systems ◽

Early Prediction ◽

Classification Tree Analysis ◽

Tree Analysis ◽

Clinical Scoring

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Evaluation of Scoring Systems in the Early Prediction of Outcomes in Acute Pancreatitis

The American Journal of Gastroenterology ◽

10.14309/00000434-201710001-00022 ◽

2017 ◽

Vol 112 ◽

pp. S13

Author(s):

Rachel Gray ◽

Joaquin Cagliani ◽

Peter C. Nauka ◽

Benjamin Villacres ◽

Tabia Santos ◽

...

Keyword(s):

Acute Pancreatitis ◽

Scoring Systems ◽

Early Prediction

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Comparative analysis of APACHE-II and P-POSSUM scoring systems in predicting postoperative mortality in patients undergoing emergency laparotomy

World Journal of Clinical Cases ◽

10.12998/wjcc.v7.i16.2227 ◽

2019 ◽

Vol 7 (16) ◽

pp. 2227-2237 ◽

Cited By ~ 3

Author(s):

Deb Sanjay Nag ◽

Ankur Dembla ◽

Pratap Rudra Mahanty ◽

Shashi Kant ◽

Abhishek Chatterjee ◽

...

Keyword(s):

Comparative Analysis ◽

Postoperative Mortality ◽

Scoring Systems ◽

Apache Ii ◽

Emergency Laparotomy

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Evaluation of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/537 ◽

2020 ◽

Vol 7 (45) ◽

pp. 2604-2610

Author(s):

Rohan J. Harsoda ◽

Sharma Vipin Jaishree ◽

Krishna Prasad G.V

Keyword(s):

Acute Pancreatitis ◽

Scoring System ◽

Scoring Systems ◽

Apache Ii ◽

Prediction Of Outcome ◽

Poor Outcome ◽

Increased Risk ◽

Highly Sensitive ◽

Poor Outcomes ◽

Ranson Score

BACKGROUND Accurate prediction of the severity of acute pancreatitis will help in identifying patients at increased risk for morbidity and mortality. We wanted to evaluate the different scoring systems in predicting the severity of acute pancreatitis. METHODS This cross-sectional study was undertaken in the Department of Surgery at a zonal hospital between April 2013 and December 2014. RESULTS 40 patients were selected and enrolled in the study as per the selection criteria. 20 (50 %) patients had fair outcome and 20 (50 %) had a poor outcome. Accuracy of different scoring systems in predicting patient outcome ranged from 45 % (48-hr APACHE II) to 62.5 % (Goris MOF at baseline and 48 hr). Baseline Goris MOF was 70 % sensitive and 55 % specific in prediction of poor outcome. It had an accuracy of 62.5 % in prediction of outcome. 48-hr Goris MOF was 80 % sensitive and 45 % specific in predicting the outcome. Baseline APACHE II scores were below the cut-off level in all the patients. 48-hr APACHE II scores were 5 % sensitive and 100% specific for prediction of outcome. Ranson score > 3 was 25 % sensitive and 90 % specific in the prediction of outcome. Balthazar score > 6 was 65 % sensitive and 55 % specific in prediction of outcome. Ranson score was found to have a limited sensitivity for different outcomes (ranging from 21.1 % to 50 %) but was found to have a high specificity (83.8 % to 90 %). CONCLUSIONS Goris scoring system (at 48 hrs) was found to be highly sensitive to different poor outcomes as well as duration of hospital stay. It also correlated with Balthazar scoring system, which was also highly sensitive to different poor outcomes studied. KEYWORDS Acute Pancreatitis, Prediction, Scoring System, APACHE II, Goris MOF, Ranson’s Score, Balthazar Score

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Balthazar Computed Tomography Severity Index Is Superior to Ranson Criteria and APACHE II and III Scoring Systems in Predicting Acute Pancreatitis Outcome

Journal of Clinical Gastroenterology ◽

10.1097/00004836-200303000-00013 ◽

2003 ◽

Vol 36 (3) ◽

pp. 253-260 ◽

Cited By ~ 53

Author(s):

Constantinos Chatzicostas ◽

Maria Roussomoustakaki ◽

Emmanouel Vardas ◽

John Romanos ◽

Elias A. Kouroumalis

Keyword(s):

Computed Tomography ◽

Acute Pancreatitis ◽

Scoring Systems ◽

Severity Index ◽

Apache Ii

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Severity markers in patients with acute pancreatitis

Open Medicine ◽

10.2478/s11536-014-0501-5 ◽

2014 ◽

Vol 9 (4) ◽

pp. 556-564 ◽

Cited By ~ 1

Author(s):

Abdullah Kisaoglu ◽

Bulent Aydinli ◽

Gurkan Ozturk ◽

Sabri Atamanalp ◽

Bunyami Ozogul ◽

...

Keyword(s):

Acute Pancreatitis ◽

High Sensitivity ◽

Scoring Systems ◽

Serum Levels ◽

Apache Ii ◽

Control Group ◽

Correct Prediction ◽

Total N ◽

The Mean ◽

The Difference

AbstractTo evaluate the effectiveness of serum levels of resistin and CD14 expression in monocytes, and high-sensitivity C-reactive protein (hsCRP) in early stages of acute pancreatitis and correct prediction of the severity of acute pancreatitis (AP) using scoring systems. The study involved 10 (29.41%) male and 24 (70.59%) female patients (total n=34) followed for AP diagnosis at the Department of General Surgery, Ataturk University Medical School between July 2008 and September 2009. In all the patients, Ranson and APACHE II scores, serum resistin, hsCRP, and monocyte CD14 expression levels were determined. The patients were divided into two groups as mild and severe AP groups. A control group was formed and the intergroup comparisons were made. Values ≥ 3 based on the Ranson scoring scale and values ≥ 8 in APACHE II scoring scale were considered to indicate severe AP. Evaluations were based on the values obtained on the 1st and 7th days for serum resistin and hsCRP levels and monocyte CD 14 expression. In 17 (50%) patients, severe AP was determined. No statistically significant differences were found between the mean serum resistin levels of AP groups, while the difference for the same parameter between the mild and severe AP groups and the control group was statistically significant. In the severe AP group, the mean 1st day and 7th day serum hsCRP levels were statistically significantly higher. The CD14 expression in monocytes was similar in all the groups. Serum hsCRP concentrations and Ranson and APACHE II scores and serum resistin and hsCRP concentrations on the 1st day were positively correlated. Serum hsCRP measurement is effective in determining the severity of acute pancreatitis. Serum resistin measurement may be a useful early marker in determining the inflammatory response in AP. However, CD14 expression in monocytes was not found to be a useful marker in the diagnosis and prediction of the disease severity in AP patients.

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