A comparative study of BISAP, Ranson’s score, APACHE II score and modified CT severity index in predicting morbidity and mortality of acute pancreatitis

Background: Acute pancreatitis is an inflammatory process with a highly variable clinical course. The present study was conducted to assess severity of acute pancreatitis.Methods: The present study was conducted on 53 patients of acute pancreatitis of both genders. A thorough clinical examination was performed. Ranson’s score (RS), Glasgow score (GS), acute physiology and chronic health evaluation (APACHE-II) score, APACHE-O score and Balthazar’s computed tomography severity index (CTSI) score was recorded.Results: Out of 53 patients, males were 47 and females were 6. Patients were divided into acute pancreatitis (32) and severe pancreatitis (21). Results of the bivariate analysis of Ranson scoring system in mild periodontitis was 0.84 in severe was 2.95, Glasgow score was 0.66 in mild and 2.48 in severe, APACHE-II had 6.94 in mild and 10.33 in severe, APACHE-O had 7.34 in mild and 11 in severe and CTSI had 1.9 in mild and 6.15 in severe.Conclusions: Authors found that all the scoring systems are useful in assessing the severity of acute pancreatitis.

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Predicting morbidity and mortality in acute pancreatitis in an Indian population: a comparative study of the BISAP score, Ranson’s score and CT severity index

Gastroenterology Report ◽

10.1093/gastro/gov009 ◽

2015 ◽

Vol 4 (3) ◽

pp. 216-220 ◽

Cited By ~ 5

Author(s):

Jitin Yadav ◽

Sanjay Kumar Yadav ◽

Satish Kumar ◽

Ranjan George Baxla ◽

Dipendra Kumar Sinha ◽

...

Keyword(s):

Acute Pancreatitis ◽

Comparative Study ◽

Indian Population ◽

Severity Index ◽

Morbidity And Mortality

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A study of interventions and their outcome in the management of acute pancreatitis

International Surgery Journal ◽

10.18203/2349-2902.isj20194044 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3128

Author(s):

Muppa Viswanath ◽

Rakesh R. ◽

Supreeth Kumar Reddy Kunnuru ◽

Raghu Sri Charan Perubhotla ◽

Mayank Kumar Gurjar ◽

...

Keyword(s):

Acute Pancreatitis ◽

Necrotizing Pancreatitis ◽

Severity Index ◽

Apache Ii ◽

Special Treatment ◽

Apache Ii Score ◽

Severe Pancreatitis ◽

Common Causes ◽

Edematous Pancreatitis ◽

Overall Mortality

Background: Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera. The suddenness of its onset, the illimitable agony which accompanies it, and the mortality attendant upon it, all render it the most formidable of catastrophes. Aim of the study is to evaluate the treatment outcome in acute pancreatitis.Methods: All the patients who underwent surgery for chronic pancreatitis were included in the study. initial APACHE II score at admission and CT severity index was evaluated.Results: Edematous pancreatitis accounts for 80–90% of acute pancreatitis and remission can be achieved in most of the patients without receiving any special treatment. Necrotizing pancreatitis occupies 10–20% of acute pancreatitis and the mortality rate is reported to be 14-25%. Alcohol (45.8%) was the most common causes of acute severe pancreatitis in this study. Males were predominately affected (Male: Female = 29:5). Complication rate or morbidity is 50%. The initial APACHE II score at admission and CT severity index in the first scan were high in patients who underwent necrosectomy and the patients who died. The overall mortality in this study was 30.6%.Conclusions: In conclusion, one reason attributed to high mortality was due to the subgroup of patients who underwent PCD alone and failed to show any change in the recovery nor deterioration and lead to gross nutritional depletion and death, secondly those patients who underwent step up approach and ultimately needed surgery have more aggressive disease evidenced by high APACHE II score, CT severity index and % of necrosis.

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Procalcitonin and BISAP score versus c-reactive protein and APACHE II score in early assessment of severity and outcome of acute pancreatitis

Vojnosanitetski pregled ◽

10.2298/vsp1205425b ◽

2012 ◽

Vol 69 (5) ◽

pp. 425-431 ◽

Cited By ~ 12

Author(s):

Mihailo Bezmarevic ◽

Zoran Kostic ◽

Miodrag Jovanovic ◽

Sasa Mickovic ◽

Darko Mirkovic ◽

...

Keyword(s):

Acute Pancreatitis ◽

Severe Form ◽

Apache Ii ◽

Apache Ii Score ◽

Serum Concentrations ◽

Key Factors ◽

Early Assessment ◽

Adequate Treatment ◽

Reactive Protein ◽

Score Apache

Background/Aim. Early assessment of severity and continuous monitoring of patients are the key factors for adequate treatment of acute pancreatitis (AP). The aim of this study was to determine the value of procalcitonin (PCT) and Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system as prognostic markers in early stages of AP with comparison to other established indicators such as Creactive protein (CRP) and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Methods. This prospective study included 51 patients (29 with severe AP). In the first 24 h of admission in all patients the APACHE II score and BISAP score, CRP and PCT serum concentrations were determined. The values of PCT serum concentrations and BISAP score were compared with values of CRP serum concentrations and APACHE II score, in relation to the severity and outcome of the disease. Results. Values of PCT, CRP, BISAP score and APACHE II score, measured at 24 h of admission, were significantly elevated in patients with severe form of the disease. In predicting severity of AP at 24 h of admission, sensitivity and specificity of the BISAP score were 74% and 59%, respectively, APACHE II score 89% and 69%, respectively, CRP 75% and 86%, respectively, and PCT 86% and 63%, respectively. It was found that PCT is highly significant predictor of the disease outcome (p < 0,001). Conclusion. In early assessment of AP severity, PCT has better predictive value than CRP, and similar to the APACHE II score. APACHE II score is a stronger predictor of the disease severity than BISAP score. PCT is a good predictor of AP outcome.

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Soluble B7-H5 Is a Novel Diagnostic, Severity, and Prognosis Marker in Acute Pancreatitis

BioMed Research International ◽

10.1155/2021/1223850 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Ruoxin Xu ◽

Ju Gong ◽

Wei Chen ◽

Yakang Jin ◽

Jian Huang

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Severe Acute Pancreatitis ◽

Apache Ii ◽

Apache Ii Score ◽

Prognosis Marker ◽

Score Apache ◽

Marshall Score ◽

Pain Patients ◽

Ranson Score

As an important ligand in T lymphocyte costimulatory pathways, B7-H5 is involved deeply in the immune response in various diseases. However, its clinical usefulness as an early indicator in acute pancreatitis (AP) remains unclear. In this study, the levels of sB7-H5 and cytokines in plasma samples of 75 AP patients, 20 abdominal pain patients without AP, and 20 healthy volunteers were determined. Then, the correlation of sB7-H5 and clinical features, cytokines, the Ranson score, APACHE II score, Marshall score, and BISAP score was analysed, and the value of sB7-H5 for diagnostic, severity, and prognosis of AP was evaluated. We found that the levels of sB7-H5 were specifically upregulated in AP patients. Receiver operating characteristic (ROC) analysis revealed that sB7-H5 can identify AP patients from healthy or abdominal pain patients with 78.9% or 86.4% sensitivity and 93.3% or 90.0% specificity. Further analysis showed that the levels of sB7-H5 were significantly correlated with WBC ( p = 0.004 ), GLU ( p = 0.008 ), LDH ( p < 0.001 ), Ca2+ ( p = 0.006 ), AST ( p = 0.009 ), PLT ( p = 0.041 ), IL-6 ( p < 0.001 ), IL-10 ( p < 0.001 ), and TNF-α ( p < 0.001 ). And levels of sB7-H5 were gradually increased among patients with mildly acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). It can distinguish the severity of AP with good sensitivity and specificity. Moreover, when dividing the patients into two groups according to the median level of sB7-H5, the local complication and length of stay of low levels of the sB7-H5 group were significantly less than those in high levels of the sB7-H5 group. And the levels of sB7-H5 in AP patients were significantly correlated with the Ranson score ( p < 0.001 ), APACHE II score ( p < 0.001 ), Marshall score ( p < 0.001 ), and BISAP score ( p < 0.001 ). The AUCs of assessing local complications of sB7-H5 at day 1 and day 3 were 0.704 ( p = 0.0024 ) and 0.727 ( p = 0.0373 ). These results showed the potential value of sB7-H5 as a diagnostic, severity, and prognosis marker of AP.

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Correlates of Morbidity and Mortality in Severe Necrotizing Pancreatitis

ISRN Surgery ◽

10.5402/2012/215193 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

K. M. Pal ◽

Pashtoon Murtaza Kasi ◽

Mohammad Tayyeb ◽

S. M. Faisal Mosharraf ◽

Zafar Fatmi

Keyword(s):

Pancreatic Necrosis ◽

Necrotizing Pancreatitis ◽

Apache Ii ◽

Morbidity And Mortality ◽

Apache Ii Score ◽

High Morbidity ◽

Unit Increase ◽

Group A ◽

Score Apache ◽

Group B

Acute severe pancreatitis is associated with a high morbidity and mortality and frequently is accompanied by underlying pancreatic parenchymal necrosis. Patients with pancreatic necrosis must be identified, because the morbidity and mortality rate in this subgroup is much higher. Our objective was to compare the clinical outcomes of these patients based on the degree of pancreatic necrosis. A total of 35 patients were noted to have pancreatic necrosis. These were divided into 2 groups based on extent of necrosis: group A had less than 50% necrosis and group B had more than 50% necrosis. The rate of mortality (5% versus 40%) was significantly higher in group B. The rate of organ dysfunction also rose along with the rates of other morbidities and variables that were related to a patient’s hospital stay. Only APACHE II significantly correlated with the degree of necrosis, wherein the chances of substantial necrosis rose by 20% with each unit increase of APACHE II score. APACHE II Score could be employed and studied further prospectively to help identify patients with pancreatic necrosis.

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A comparative study of marshall score versus apache-II score in assessing severity of acute pancreatitis

Hellenic Journal of Surgery ◽

10.1007/s13126-016-0275-0 ◽

2016 ◽

Vol 88 (1) ◽

pp. 5-12 ◽

Cited By ~ 1

Author(s):

Swatantra Nagendra Rao ◽

Arun Kumar Gupta ◽

Ashirwad Karigoudar ◽

Nikhil Gupta ◽

C. K. Durga

Keyword(s):

Acute Pancreatitis ◽

Comparative Study ◽

Apache Ii ◽

Apache Ii Score ◽

Marshall Score

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Comparison of Multifactor Vs Independent Marker in Predicting Severity of Acute Pancreatitis

Academia Journal of Surgery ◽

10.47008/ajs/2020.3.1.30 ◽

2020 ◽

Vol 3 (1) ◽

pp. 136-141

Author(s):

Vijaykumar C Bada

Keyword(s):

Acute Pancreatitis ◽

Organ Failure ◽

Apache Ii ◽

Apache Ii Score ◽

Pmn Elastase ◽

Severe Pancreatitis ◽

Poor Predictor ◽

Score Apache ◽

Pmn Élastase ◽

Independent Marker

Background: Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. This study was conducted to compare the multifactor vs independent marker in predicting the severity of acute pancreatitis. Subjects and Methods: The present study comprised of 50 patients of acute pancreatitis. In all patients, reactive protein (CRP), Interleukin-6 (IL-6), PMN-Elastase (PMN-E), Procalcitonin (PCT), RANSON”s score, GLASGOW score, APACHE-II score, APACHE-O score and Balthazar’s CTSI score was recorded. Results: There were 45 males and 5 females in the study. There were 12 (22.64%) obese patients in this study. The age of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age was a poor predictor of the severity of acute pancreatitis. Obesity of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age is a poor predictor of the severity of acute pancreatitis. Organ failure at admission is more likely to reflect severe cases, it is found to be a poor predictor of severity in acute pancreatitis. The mean CTSI score in the study was 3.57 (SD 2.64), with a median of 2 and ranged from 1 to 10. It was higher in severe pancreatitis and a CTSI score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis. Conclusion: The authors found that overall, CRP was the best predictor, followed by IL-6, CTSI score, PCT, Glasgow, Ranson’s and APACHE-II. PMN-Elastase, Age, obesity and organ failure at admission are poor predictors of severity of acute pancreatitis.

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