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

Bezmarević, Mihailo; Kostić, Zoran; Jovanović, Miloš; Micković, Saša; Mirković, Darko; Soldatović, Ivan; Trifunović, Bratislav; Pejović, Janko; Vujanić, Svetlana

doi:10.2298/vsp1205425b

Cited by 24 publications

(11 citation statements)

References 43 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the patients have mild disease with minimal morbidity, and the rest of the patients have 10%-20% of mortality in SAP [6]. In this study based on MCSI, there were 69 (42%) SAP patients who are similar to Bezmarevic et al study [7]. Cho et al in their study of 161 AP patients reported that 52 patients with SAP had APACHE II score ≥8 similar to this study [8].…”

Section: Discussionsupporting

confidence: 68%

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Venkatesh¹,

Vijayakumar²,

Balasubramaniyan³

et al. 2020

Cureus

View full text Add to dashboard Cite

Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas mostly due to alcohol or gallstones. Various scoring systems were involved in identifying the severity of the disease. The standard single score to identifying the severity remains uncertain. Methodology This prospective observational study was carried out for two years in a tertiary care center from South India. The diagnosis of AP was made based on Atlanta criteria, and a total of 164 patients were included. All patients were assessed by acute physiology and chronic health evaluation ll (APACHE II), bedside index for severity in AP (BISAP), modified Glasgow score (MGS), and Ranson score on admission and 48 hours after admission scores. Procalcitonin was done in all patients with AP. Contrast-enhanced computed tomography (CT) of the abdomen was done in 69 patients who had features of severe acute pancreatitis (SAP). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for each score, and procalcitonin for CT documented severe patients and organ failure patients together. Results A total of 164 patients were included in this study. CT abdomen showed a modified CT severity index (MCSI) ≥8 in all 69 (100%) patients. APACHE II score could predict SAP based on CT findings in 44 patients (63.76%), BISAP score in 22 patients (31.88%), MGS in 55 patients (79.71%), Ranson score at admission in 31 patients (44.92%), Ranson score 48 hours after admission in 44 patients (63.76%), and procalcitonin on admission in 69 patients (100%) when cutoff used as per the literature. APACHE II score could predict SAP in cases of AP (n=164) in 52 patients (50%), BISAP score in 27 patients (26%), MGS in 79 patients (76%), Ranson score at admission in 34 patients (33%), and Ranson score 48 hours after admission in 61 (59%) patients when cutoff was used as per the literature. This study demonstrated that Ranson score on admission had a good area under the curve (AUC). AUC (0.8483), APACHE II (AUC 0.7708), and Ranson score 48 hours after admission (AUC 0.8167) had a fair accuracy. BISAP (AUC 0.6399) and MGS (AUC 0.6486) had poor accuracy for the prediction of severity in AP based on receiver operator characteristic (ROC) curves.

show abstract

Section: Discussionsupporting

confidence: 68%

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Venkatesh¹,

Vijayakumar²,

Balasubramaniyan³

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…Ten studies were excluded due to insufficient data to calculate the effect estimates, leaving thirteen studies included into the qualitative synthesis. Further, two records were excluded as they studied SAP defined by the 1992 Atlanta classification [ 18 , 19 ]. Two studies investigated the same cohort [ 20 , 21 ], and the study with more comprehensive data was selected [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis

2015

View full text Add to dashboard Cite

PurposeThe Bedside Index for Severity in Acute Pancreatitis (BISAP) score has been developed to identify patients at high risk for mortality or severe disease early during the course of acute pancreatitis. We aimed to undertake a meta-analysis to quantify the accuracy of BISAP score for predicting mortality and severe acute pancreatitis (SAP).Materials and MethodsWe searched the databases of Pubmed, Embase, and the Cochrane Library to identify studies using the BISAP score to predict mortality or SAP. The pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR) were calculated from each study and were compared with the traditional scoring systems.ResultsTwelve cohorts from 10 studies were included. The overall sensitivity of a BISAP score of ≥3 for mortality was 56% (95% CI, 53%-60%), with a specificity of 91% (95% CI, 90%-91%). The positive and negative likelihood ratios were 5.65 (95% CI, 4.23-7.55) and 0.48 (95% CI, 0.41-0.56), respectively. Regarding the outcome of SAP, the pooled sensitivity was 51% (43%-60%), and the specificity was 91% (89%-92%). The pooled positive and negative likelihood ratios were 7.23 (4.21-12.42) and 0.56 (0.44-0.71), respectively. Compared with BISAP score, the Ranson criteria and APACHEⅡscore showed higher sensitivity and lower specificity for both outcomes.ConclusionsThe BISAP score was a reliable tool to identify AP patients at high risk for unfavorable outcomes. Compared with the Ranson criteria and APACHEⅡscore, BISAP score outperformed in specificity, but having a suboptimal sensitivity for mortality as well as SAP.

show abstract

“…The pooled sensitivity and specificity values were 64.82 and 83.62%, respectively, from the meta-analysis of the diagnostic performance of the BISAP in 1,972 individuals from 9 research studies [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ], indicating a good specificity but moderate sensitivity in diagnosing SAP. These sensitivity and specificity values confirmed the findings of several other studies that the BISAP score was a reliable and accurate means for predicting the severity of AP in the early phase [ 10 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Of these 18 articles, 9 were excluded: 4 non-English language articles, 3 reviews and 2 studies without sufficient data for calculations. Finally, 9 studies [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ] that involved 1,972 subjects were included in the meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the Ability of the Bedside Index for Severity of Acute Pancreatitis Score to Predict Severe Acute Pancreatitis: A Meta-Analysis

Yang

Li²

2015

Med Princ Pract

View full text Add to dashboard Cite

Objective: To evaluate the diagnostic performance of the bedside index for severity in acute pancreatitis (BISAP) score in predicting severe acute pancreatitis (SAP). Materials and Methods: A systematic search was conducted using PubMed, Cochrane library and EMBASE databases up to May 2014, and 9 related studies, including 1,972 subjects, were reviewed. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnosis of odds ratio (DOR) and hierarchic summary receiver-operating characteristic (HSROC) curves, as well as the area under the HSROC curve (AUC), were assessed using the HSROC and bivariate mixed effects models. Moreover, a subgroup analysis stratified by cutoff value was performed to measure the effect of the diagnostic threshold on the performance of the BISAP score. Finally, publication bias was assessed using Deeks' funnel plot asymmetry test. Statistical analyses were performed using the STATA 12.0 software. Results: The pooled sensitivity, specificity, PLR, NLR and DOR of the BISAP for predicting SAP were 64.82% (95% CI: 54.47-73.74%), 83.62% (95% CI: 70.03-91.77%), 3.96 (95% CI: 2.27-6.89), 0.42 (95% CI: 0.34-0.52) and 9.41 (95% CI: 5.38-16.45), respectively. The AUC was 0.77 (95% CI: 0.73-0.80). Moreover, the subgroup analysis results demonstrated that the BISAP cutoff point at 3 had a higher specificity and greater accuracy than at 2 to predict SAP. No significant publication bias was detected across the studies (p = 0.359). Conclusion: The BISAP score showed low sensitivity but high specificity for assessing the severity of acute pancreatitis.

show abstract

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

Abstract: 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.

Cited by 24 publications

References 43 publications

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Evaluating the Ability of the Bedside Index for Severity of Acute Pancreatitis Score to Predict Severe Acute Pancreatitis: A Meta-Analysis

Contact Info

Product

Resources

About