Guzmán Calderon Edson, Montes Teves Pedro, Monge Salgado Eduardo
Departamento del Aparato Digestivo del Hospital Nacional Edgardo Rebagliati Martins.
Rev Gastroenterol Peru. 2012 Jul-Sep;32(3):251-6.
Most patients with acute pancreatitis exhibits a self-limiting clinical course and relatively free of major complications. Several scores have been created with the intention of achieving adequate and early predict the severity of pancreatitis in order to reduce this mortality. BISAP score was validated in 2008 as a predictor of mortality for acute pancreatitis, obesity is an independent risk factor that increases the risk of severity in patients with acute pancreatitis.The aim of this study is to determine whether obesity BISAP added a score improves prediction of severity in patients with acute pancreatitis.
This study was conducted in Daniel Alcides Carrión Hospital, Lima, Peru. The patient data were collected in the Emergency Service, it was a cross-sectional retrospective study, between January 2009 and June 2010.
We evaluated a total of 99 patients with acute pancreatitis. Etiology of the 99 were biliary pancreatitis. Only 2 ended in death (2%). Most cases occurred in female patients 77/22 (77.8%). Sixteen of the 99 patients (16%) were considered severe acute pancreatitis. 90% (89/99) had a BISAP <3, 10% a BISAP ≥ 3, fifteen of the 99 patients had a BISAP-O> 3, of them 12 were actually considered a severe pancreatitis. Of 16 patients with severe pancreatitis, 14 patients had a BMI>25. (P = 0.03, OR = 4.39). BISAP-O has a sensitivity, specificity, PPV and NPV of 75%, 96.4%, 80% and 95.2% respectively, with an accuracy of 92.3%. The area under the curve for BISAP-O was 0.94 (95% CI 0.89 to 0.99). There was no difference when compared with the other studied scores (p = 0.45).
BISAP The score is a simple method that can be used to predict the severity of acute pancreatitis. Obesity associated BISAP (BISAP-O) provides higher sensitivity and diagnostic accuracy to score BISAP and can serve as a parameter to help predict severity in patients with acute pancreatitis. It was not possible to assess the BISAP-O score as a predictor of mortality for patients with acute pancreatitis, due to the low mortality rate in the present study. Further studies are required to validate the score BISAP associated with obesity in predicting severity.
大多数急性胰腺炎患者呈现自限性临床病程，且相对较少发生严重并发症。为了充分且早期预测胰腺炎的严重程度以降低死亡率，已创建了多个评分系统。BISAP评分于2008年被证实可作为急性胰腺炎死亡率的预测指标，肥胖是增加急性胰腺炎患者病情严重风险的独立危险因素。本研究的目的是确定加入肥胖因素的BISAP评分是否能改善对急性胰腺炎患者病情严重程度的预测。
本研究在秘鲁利马的丹尼尔·阿尔西德斯·卡里翁医院进行。患者数据收集于急诊室，这是一项2009年1月至2010年6月期间的横断面回顾性研究。
我们共评估了99例急性胰腺炎患者。99例患者的病因均为胆源性胰腺炎。仅2例死亡（2%）。大多数病例发生在女性患者中，77/22（77.8%）。99例患者中有16例（16%）被认为是重症急性胰腺炎。90%（89/99）的患者BISAP<3，10%的患者BISAP≥3，99例患者中有15例BISAP-O>3，其中12例实际被认为是重症胰腺炎。在16例重症胰腺炎患者中，14例患者的BMI>25。（P = 0.03，OR = 4.39）。BISAP-O的敏感性、特异性、阳性预测值和阴性预测值分别为75%、96.4%、80%和95.2%，准确率为92.3%。BISAP-O的曲线下面积为0.94（95%CI 0.89至0.99）。与其他研究的评分相比无差异（p = 0.45）。
BISAP评分是一种可用于预测急性胰腺炎严重程度的简单方法。与肥胖相关的BISAP（BISAP-O）对BISAP评分具有更高的敏感性和诊断准确性，可作为帮助预测急性胰腺炎患者病情严重程度的一个参数。由于本研究中死亡率较低，无法将BISAP-O评分评估为急性胰腺炎患者死亡率的预测指标。需要进一步研究以验证与肥胖相关的BISAP评分在预测病情严重程度方面的作用。
