Comparison of the BUN/albumin ratio and BISAP score in predicting severity of acute pancreatitis
Öz
Purpose: This study evaluated patients diagnosed with acute pancreatitis in the emergency department by comparing the BUN/Albumin Ratio (BAR) and BISAP scores to indicate disease severity and prognosis.
Materials and Methods: 457 patients diagnosed with acute pancreatitis between 2016 and 2021 were included in this observational study, which was planned retrospectively. The laboratory data of the patients and the calculated BISAP scores were recorded.
Results: Patients were categorized according to the BISAP score; 385 (84.2%) patients were at low risk for acute pancreatitis, while 72 (15.8%) were at high risk. The AUC for BAR values was 0.757 (75.7%), and this was statistically significant for determining cutoff values, with a cutoff value of >4.60 (p<0.001). Regression analysis of the BAR value was performed for the BISAP categories. As the BAR value increased, the BISAP high-risk value increased 38,339 times. The sensitivity ratio between BAR and BISAP evaluation criteria was found to be 68.67% (0.60-0.75), and it was determined that the BAR value was as strongly correlated with the severity of the disease as the BISAP score.
Conclusion: This study shows that BAR is as effective as BISAP scores in determining high-risk acute pancreatitis.
Anahtar Kelimeler
BUN/albumın ratıo, Emergency department, acute pancreatitis, BISAP
Kaynakça
- Singer MV, Gyr K, Sarles H. Revised classification of pancreatitis: Report of the Second International Symposium on the Classification of Pancreatitis in Marseille, France. Gastroenterology. 1985;89:683-5.
- Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.
- Buter A, Imrie CW, Carter CR, Evans S, McKay CJ. The dynamic nature of early organ dysfunction determines the outcome of acute pancreatitis. Br J Surg. 2002;89:298-302.
- Al-Qahtani HH, Alam MKh, Waheed M. Comparison of harmless acute pancreatitis score with ranson's score in predicting the severity of acute pancreatitis. J Coll Physicians Surg Pak. 2017;27:75-9.
- Simchuk EJ, Traverso LW, Nukui Y, Kozarek RA. Computed tomography severity index is a predictor of outcomes for severe pancreatitis. Am J Surg. 2000;179:352-5.
- Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698-703.
- Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019;13:14-27.
- Shorr AF, Sun X, Johannes RS, Yaitanes A, Tabak YP. Validation of a novel risk score for severity of illness in acute exacerbations of COPD. Chest. 2011;140:1177–83.
- Faisst M, Wellner UF, Utzolino S, Hopt UT, Keck T. Elevated blood urea nitrogen is an independent risk factor of prolonged intensive care unit stay due to acute necrotizing pancreatitis. J Crit Care. 2010;25:105–11.
- Hong W, Lin S, Zippi M, Geng W, Stock S, Basharat Z et al. Serum albumin is independently associated with persistent organ failure in acute pancreatitis. Can J Gastroenterol Hepatol. 2017;14:124-35.
