CAJ | 학술논문

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. <br> 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. <br> 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). <br> 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.