Akut Pankreatitli Hastalarda Mortaliteyi Öngörmede BAR, BISAP ve NEWS Skorlarının Karşılaştırılması

Abstract

Amaç: Akut pankreatit, yüksek mortalite oranına sahip bir gastrointestinal acil durumdur. Akut pankreatitte mortaliteyi öngörmek için çeşitli biyobelirteçler ve skorlama sistemleri kullanılmaktadır. BISAPS (Bedside Index of Severity of Acute Pancreatitis Score) ve NEWS (National Early Warning Score) gibi geleneksel yöntemler çok fazla parametre içermektedir. Bu çalışmada, acil servise başvuran akut pankreatitli hastalarda BUN/Albümin oranı (BAR) ile mortalitenin öngörülmesi amaçlandı. Gereç ve Yöntem: 01/01/2021 ile 31/12/2022 tarihleri arasında acil servise başvuran ve lipaz değeri referans değerin üç katından fazla olan hastalar, hastane verileri retrospektif olarak taranarak çalışmaya dahil edildi. Hastalar, hastane içi mortaliteye göre iki gruba ayrıldı. Tüm hastaların BAR, BISAP ve NEWS değerleri hesaplanarak karşılaştırıldı. Bulgular: Mortaliteyi öngörme gücünü değerlendirmek için yapılan ROC analizinde; AUC değerleri NEWS için 0,637 (0.546-0.727), BISAPS için 0,684 (0.589-0.779), BAR için 0,748 (0.663-0.832) olarak bulundu. Lojistik regresyon analizinde; BAR, akut pankreatitli hastalarda hastane içi mortalitenin en güçlü bağımsız belirleyicisi olarak bulundu. BAR’da 1 birimlik artışın hastane içi mortaliteyi 1,071 kat artırdığı tespit edildi. Sonuç: Acil servise başvuran akut pankreatitli hastalarda, BAR skoru, NEWS ve BISAPS skorlarına göre mortaliteyi öngörmede daha etkilidir.

Keywords

• Akut Pankreatit
• BAR
• BISAPS
• NEWS
• Mortalite

Comparison of BAR, BISAP and NEWS Scores in Predicting Mortality in Patients with Acute Pancreatitis

Abstract

Objective: Acute pancreatitis is a gastrointestinal emergency with a high mortality rate. Multiple biomarkers and scoring systems are used to predict mortality in acute pancreatitis. Traditional methods such as BISAPS (Bedside Index of Severity of Acute Pancreatitis Score) and NEWS (National Early Warning Score) contain too many parameters. To predict mortality in patients with acute pancreatitis who apply to the emergency department with the BUN/Albumin ratio (BAR). Material and Method: Patients who were admitted to the emergency department between 01/01/2021 and 31/12/2022 and whose lipase value was more than three times the reference value were included in our study by retrospectively scanning hospital data.Patients were divided into two groups according to in-hospital mortality. BAR, BISAP and NEWS values of all patients were calculated and compared. Result: In the ROC analysis performed to evaluate the mortality predictive power; AUC values of NEWS 0.637 (0.546-0.727), BISAPS 0.684 (0.589-0.779), BAR 0.748 (0.663-0.832) were obtained. In the logistic regression analysis; BAR was found to be the highest independent predictor of in-hospital mortality of acute pancreatitis. It was found that a 1 unit increase in BAR increased in-hospital mortality by 1,071 times. Conclusions: BAR is more effective in predicting mortality than NEWS and BISAPS in patients with acute pancreatitis who present to the emergency department.

Keywords

• Acute Pancreatitis
• BAR
• BISAPS
• NEWS
• Mortality

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