床边急性胰腺炎严重程度指数：与其他评分系统预测严重程度和器官衰竭的比较。
Bedside index for severity in acute pancreatitis: comparison with other scoring systems in predicting severity and organ failure.
机构信息
Division of Gastroenterology, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea.
出版信息
Hepatobiliary Pancreat Dis Int. 2013 Dec;12(6):645-50. doi: 10.1016/s1499-3872(13)60101-0.
BACKGROUND
The early identification of severe acute pancreatitis is important for the management and for improving outcomes. The bedside index for severity in acute pancreatitis (BISAP) has been considered as an accurate method for risk stratification in patients with acute pancreatitis. This study aimed to evaluate the comparative usefulness of the BISAP.
METHODS
We retrospectively analyzed 303 patients with acute pancreatitis diagnosed at our hospital from March 2007 to December 2010. BISAP, APACHE-II, Ranson criteria, and CT severity index (CTSI) of all patients were calculated. We stratified the number of patiants with severe pancreatitis, pancreatic necrosis, and organ failure as well as the number of deaths by BISAP score. We used the area under the receiver-operating curve (AUC) to compare BISAP with other scoring systems, C-reactive protein (CRP), hematocrit, and body mass index (BMI) with regard to prediction of severe acute pancreatitis, necrosis, organ failure, and death.
RESULTS
Of the 303 patiants, 31 (10.2%) were classified as having severe acute pancreatitis. Organ failure occurred in 23 (7.6%) patients, pancreatic necrosis in 40 (13.2%), and death in 6 (2.0%). A BISAP score of 2 was a statistically significant cutoff value for the diagnosis of severe acute pancreatitis, organ failure, and mortality. AUCs for BISAP predicting severe pancreatitis and death were 0.80 and 0.86, respectively, which were similar to those for APACHE-II (0.80, 0.87) and Ranson criteria (0.74, 0.74) and greater than AUCs for CTSI (0.67, 0.42). The AUC for organ failure predicted by BISAP, APACHE-II, Ranson criteria, and CTSI was 0.93, 0.95, 0.84 and 0.57, respectively. AUCs for BISAP predicting severity, organ failure, and death were greater than those for CRP (0.69, 0.80, 0.72), hematocrit (0.45, 0.35, 0.14), and BMI (0.41, 0.47, 0.17).
CONCLUSION
The BISAP predicts severity, death, and especially organ failure in acute pancreatitis as well as APACHE-II does and better than Ranson criteria, CTSI, CRP, hematocrit, and BMI.
背景
早期识别重症急性胰腺炎对于治疗和改善预后非常重要。床边急性胰腺炎严重程度指数（BISAP）已被认为是一种用于评估急性胰腺炎患者风险分层的准确方法。本研究旨在评估 BISAP 的比较有用性。
方法
我们回顾性分析了 2007 年 3 月至 2010 年 12 月我院收治的 303 例急性胰腺炎患者。计算所有患者的 BISAP、APACHE-II、Ranson 标准和 CT 严重指数（CTSI）。我们根据 BISAP 评分分层严重胰腺炎、胰腺坏死和器官衰竭的患者数量以及死亡人数。我们使用受试者工作特征曲线下面积（AUC）比较 BISAP 与其他评分系统、C 反应蛋白（CRP）、血细胞比容和体重指数（BMI）在预测重症急性胰腺炎、坏死、器官衰竭和死亡方面的有效性。
结果
303 例患者中，31 例（10.2%）被诊断为重症急性胰腺炎。23 例（7.6%）患者发生器官衰竭，40 例（13.2%）发生胰腺坏死，6 例（2.0%）死亡。BISAP 评分为 2 分是诊断重症急性胰腺炎、器官衰竭和死亡率的统计学显著截断值。BISAP 预测重症胰腺炎和死亡的 AUC 分别为 0.80 和 0.86，与 APACHE-II（0.80，0.87）和 Ranson 标准（0.74，0.74）相似，大于 CTSI（0.67，0.42）的 AUC。BISAP 预测器官衰竭的 AUC 分别为 0.93、0.95、0.84 和 0.57，APACHE-II、Ranson 标准、CTSI。BISAP 预测严重程度、器官衰竭和死亡的 AUC 大于 CRP（0.69、0.80、0.72）、血细胞比容（0.45、0.35、0.14）和 BMI（0.41、0.47、0.17）。
结论
BISAP 预测急性胰腺炎的严重程度、死亡，尤其是器官衰竭，与 APACHE-II 相似，优于 Ranson 标准、CTSI、CRP、血细胞比容和 BMI。
Zotero 插件