DOI: http://dx.doi.org/10.18203/2349-2902.isj20181571

A prospective study of BISAP score in assessing severity of acute pancreatitis

Mahidhar Reddy Venkatapuram, Sreeram Sateesh, Deepthi Batchu

Abstract


Background: Aim of study is to prospectively evaluate the ability of the Bedside Index for Severity in Acute Pancreatitis (BISAP) score to predict mortality as well as intermediate markers of severity.

Methods: 50 patients admitted from December 2015 to November 2017 with acute pancreatitis were included in the study. BISAP score is calculated in all such patients based on data obtained within 24hrs of hospitalization. Patients were assessed for organ failure according to Marshall scoring system and followed throughout hospitalization for assessment of complications. Statistical analyses were made using Fischer’s exact probability test. The difference was assumed statistically significant when p<0.05.

Results: There was a statistically highly significant trend for increasing mortality (p < 0.05) and intermediate markers of severity (p<0.05) that is transient organ failure, persistent organ failure and pancreatic necrosis with BISAP score ≥3.

Conclusions: The BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24 hours of presentation.

Keywords


APACHE scoring system, Acute pancreatitis, BISAP score, Bedside index, CT grading, Modified Glasgow criteria, Ransons criteria

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References


Bradley EL 3rda clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch. 1993;128:586-590.

Fagenholz PJ, Castillo CF, Harris NS, et al. Increasing United States hospital admissions for acute pancreatitis, 1988-2003. Ann Epidermiol. 2007;17:491-7.

PA, Freeman ML, Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.

Ranson JH,Rifkind KM, Roses DF. Objective early identification of severe acutepancreatitis. Am J Gastroenterol. 1974;61:443-51.

Yeung YP, Lam BY, Yip AW. APACHE system is better than Ranson system in the prediction of Severity of acute pancreatitis Hepato Biliarypancreat Dis Int. 2006;5:294-9.

Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet. 1989;2:201-5.

Wu BU, Johannes RS, Sun X. The early prediction of mortality in acute Pancreatitis: a large population-based study. Gut. 2008;57:1698-703.

Singh VK, Wu BU, Bollen TL, Repas K, Maurer R, Johannes RS et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol. 2009;104:966-71.

Bradley EL. A clinical based classification system for acute pancreatitis. Areh Surg. 1993;128:586-90.

Forsmark CE. The clinical problem of biliary acute necrotizing pancreatitis: epidemiology, pathophysiology, and diagnosis of biliary necrotizing pancreatitis. J Gastrointest Surg. 2001;5:235-9.

Freeman ML, DiSario JA, Nelson DB. Risk factors for post-ERCP pancreatitis: a prospective, multicentre study. Gastrointest Endosc. 2001;54:425-34.

Isenmann R, Beger HG. Natural history of acute pancreatitis and the role of infection. Best Pract Rese Clin Gastroenterol. 1999;13:291-301.

Angelini G, Cavallini G, Pederzoli P. Long-term outcome of acute pancreatitis: Prospective study with 18 patients. Digestion. 1993;54:143-7.

De Beaux AC, Palmer KR, Carter DC. Factors influencing morbidity and mortality in acute pancreatitis; an analysis of 279 cases. Gut. 1995;37:12-126.

Topazian M, Gorelick F. Acute pancreatitis. Yamada T, ed. Textbook of Gastroenterology 3rd ed. Lippincott, Philadelphia, PA;1999: 2121-50.

Ranson JHC. Diagnostic standards for acute pancreatitis. World J Surg. 1997;21:136-42.

Beger HG, Rau B, Mayer J, Pralle U. Natural course of acute pancreatitis. World J Surg. 1997;21:130-5.

Mergener K, Baillie J. Acute pancreatitis. BMJ. 1998;316:44-8.

Banks P. Acute and chronic pancreatitis. In: Feldman M, Scharschmidt B, Sleisenger M, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease 6thed. Saunders, Philadelphia, PA, 1998:809-62.

Levitt MD, Eckfeldt JH. Diagnosis of acute pancreatitis. In: Go V, Dimango E, Gardner J, et al., eds. The Pancreas: Biology, Pathophysiology and Disease 2nded. Raven Press, NY;1993:613-5.

Fallat RW, Vester JW, Glueck CJ. Suppression of Amylase Activity by Hypertriglyceridemia. JAMA. 1973;225:1331-4

Triester SL, Kowdley KV. Prognostic factors in acute pancreatitis. Clin Gastroenterol. 2002;34:167-176.

Foitzik T, Bassi DG, Schmidt J, et al. Intravenous contrast medium accentuates the severity of acute necrotizing pancreatitis in the rat. Gastroenterol. 1994;106:207-14.

Baron T, Morgan D. Acute necrotizing pancreatitis. N Engl J Med. 1999;340:1412-7.

Nuutinen P, Kivisaari L, Schroder T. Contrast-enhanced computed tomography and micro angiography of the pancreas in acute human hemorrhagic/necrotizing pancreatitis. Pancreas. 1988;3:53-60.

Baillie J. Treatment of acute biliary pancreatitis. N Engl J Med. 1997;336:286-7.

Neoptolemos JP, Carr-Locke DL, Baily IA. Controlled trial of urgent endoscopic retrograde cholangio pancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet. 1988;2:979-83.

Prat F, Edery J, Meduri B, Chiche R, Ayoun C, Bodart M et al. Early EUS of the bile duct before endoscopicsphincterotomy for acute biliary pancreatitis. Gastrrointest Endosc. 2001;54:724-9.

Ranson JHC. Etiological and Prognostic factors in human acute pancreatitis: A review. Am J Gastroenterol. 1982;77:633-8.

Balthazar EJ, Ranson JH, Naidich DP, Megibow AJ, Caccavale R, Cooper MM. Acute pancreatitis: Prognostic value of CT. Radiology. 1985;156:767-72.

Balthazar E, Robinson DL, Meigibow AJ, Ranson JHC. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331-6.

Brown A, Orav J, Banks PA. Hemoconcentration is an early marker for organ failure and necrotizing pancreatitis. Pancreas. 2000;20:367-72.

Lankisch PG, Mahlke R, Blum T, Bruns A, Bruns D, Maisonneuve P et al. Hemoconcentration: An early marker of severe and/or necrotizing pancreatitis? A critical appraisal. Am J Gastroenterol. 2001;96:2081-6.

Baron T. Predicting the severity of acute pancreatitis: Is it time to concentrate on hematocrit?. Am J Gastroenterol. 2001;96:1960-1.

Whitcomb DC, Pederso MRA, Oliva J. An admission hematocrit of 40 or less predicts a low risk of pancreatic necrosis and may reduce the need for diagnostic CT scans. Gastroenterology. 1999;116:76.

Marshall JC, Cook DJ, Christou NV. Multiple organ dysfunction Score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638-52.

Kashid A. Acute pancreatitis Experience at Manipal Hospital, Bangalore, Appendix 1-A, in Management of Acute Pancreatitis, by Bhansali SK and Shah SC, Jaslok Hospital;2006:173-5.

Choudhuri G. Acute pancreatitis Experience at Sanjay Gandhi PGI of Medical Sciences, Lucknow, Appendix 1-B, in Management of Acute Pancreatitis, by Bhansali SK and Shah SC, Jaslok Hospital. 2006:176-8.

Pupelis G, Zeiza K, Plaudis H, Suhova A. Conservative approach in the management of severe acute pancreatitis: eight-year experience in a single institution. HPB. 2008;10:347-55.

Buchler MW, Gloor B, Muller CA. Acute necrotizing pancreatitis: treatment strategy according to the status of infection. Ann Surg. 2000;232:619-26.