COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34635/rpc.850 |
Resumo: | Backgrond. Early risk stratification is crucial in Acute Pancreatitis (AP). The BedSide Index for Severity in Acute Pancreatitis (BISAP) allows risk stratification at the time of hospital admission through a five-variable analysis. Several inflammatory markers have shown prognostic value in AP. Amongst them the Neutrophil to Lymphocyte Ratio has the best predictive accuracy. The Harmless Acute Pancreatitis Score (HAPS) is used to predict mild AP. Our objective was to compare BISAP, NLR and HAPS as predictors of severity in acute pancreatitis. Material and Methods. A six-year (January 2014 – December 2019) retrospective analysis of a prospective database of all the patients admitted with the diagnosis of AP. Included variables: age, sex, BISAP score, NLR, HAPS score, length of stay, severity and mortality. Severity was defined according to 2012 revision of Atlanta classification. Accuracy of prediction was measured by the area under the receiver operating characteristic curve (AUC). Positive Predictive Value (PPV), Negative Predictive Value (NPV), Sensitivity and Specificity were also calculated. Results. Total of 284 cases; 121 male and 163 female; median age was 71 years [21 – 95]. 216 patients presented mild AP, 34 moderate and 34 severe AP; overall mortality was 4.2%. The BISAP AUC for prediction of severity was 0,86 [0,796 – 0,936]. Sensivity was 44.1% and specificity was 93.2%. PPV was 68.2% and NPV was 92.8%. The NLR AUC was 0,7 [0,607 – 0,798]. Sensivity was 78.8% and specificity was 51.8%. PPV was 78.8% and NPV was 94.8%. Finally, HAPS AUC for prediction of mild AP was 0,706 [0,623 – 0,790]. Sensitivity was 60.6% and specificity was 72.1%. PPV was 87.3% and NPV was 36.6%. Conclusion. BISAP, NLR and HAPS are valuable tools for an early risk stratification and prognosis evaluation in AP. The best calculated accuracy for the prediction of severity was for BISAP. |
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COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATIONCOMPARAÇÃO DO BISAP, NLR E HAPS NA PREVISÃO DA GRAVIDADE NA PANCREATITE AGUDA, SEGUNDO A REVISÃO DE 20 12 DA CLASSIFICAÇÃO DE ATLANTABackgrond. Early risk stratification is crucial in Acute Pancreatitis (AP). The BedSide Index for Severity in Acute Pancreatitis (BISAP) allows risk stratification at the time of hospital admission through a five-variable analysis. Several inflammatory markers have shown prognostic value in AP. Amongst them the Neutrophil to Lymphocyte Ratio has the best predictive accuracy. The Harmless Acute Pancreatitis Score (HAPS) is used to predict mild AP. Our objective was to compare BISAP, NLR and HAPS as predictors of severity in acute pancreatitis. Material and Methods. A six-year (January 2014 – December 2019) retrospective analysis of a prospective database of all the patients admitted with the diagnosis of AP. Included variables: age, sex, BISAP score, NLR, HAPS score, length of stay, severity and mortality. Severity was defined according to 2012 revision of Atlanta classification. Accuracy of prediction was measured by the area under the receiver operating characteristic curve (AUC). Positive Predictive Value (PPV), Negative Predictive Value (NPV), Sensitivity and Specificity were also calculated. Results. Total of 284 cases; 121 male and 163 female; median age was 71 years [21 – 95]. 216 patients presented mild AP, 34 moderate and 34 severe AP; overall mortality was 4.2%. The BISAP AUC for prediction of severity was 0,86 [0,796 – 0,936]. Sensivity was 44.1% and specificity was 93.2%. PPV was 68.2% and NPV was 92.8%. The NLR AUC was 0,7 [0,607 – 0,798]. Sensivity was 78.8% and specificity was 51.8%. PPV was 78.8% and NPV was 94.8%. Finally, HAPS AUC for prediction of mild AP was 0,706 [0,623 – 0,790]. Sensitivity was 60.6% and specificity was 72.1%. PPV was 87.3% and NPV was 36.6%. Conclusion. BISAP, NLR and HAPS are valuable tools for an early risk stratification and prognosis evaluation in AP. The best calculated accuracy for the prediction of severity was for BISAP. Introdução. A estratificação precoce do risco é essencial na Pancreatite Aguda (PA). O BedSide Index for Severity in Acute Pancreatitis (BISAP) permite estratificar o risco na admissão hospitalar através da análise de cinco variáveis. Vários marcadores inflamatórios demonstraram valor prognóstico na PA. Entre eles, a razão Neutrófilos / Leucócitos (NLR) possui a melhor capacidade preditiva. O Harmless Acute Pancreatitis Score (HAPS) é utilizado para a previsão de formas ligeiras de PA. o objectivo deste trabalho é comparar o BISAP, NLR e o HAPS na previsão da gravidade na PA. Material e Métodos. Análise retrospectiva de seis anos (Janeiro 2014 – Dezembro 2019) de base de dados prospectiva de todos os doentes consecutivos internados com o diagnóstico de PA. Variáveis incluídas: idade, sexo, score BISAP, NLR, score HAPS, duração de internamento, gravidade e mortalidade. A gravidade foi avaliada de acordo com critérios de Atlanta revistos em 2012. A capacidade preditiva foi avaliada pela área sob a curva (AUC) ROC, tendo sido determinados também o valor preditivo positivo (VPP) e o valor preditivo negativo (VPN), sensibilidade e especificidade. Resultados. Amostra de 284 doentes consecutivos; 121 homens e 163 mulheres; mediana de idade de 71 anos [21 – 95]. 216 doentes apresentaram PA Ligeira, 34 Moderada e 34 Grave; mortalidade global de 4.2%. O BISAP apresentou para a predição de gravidade uma AUC de 0,86 [0,796 – 0,936], Sensibilidade de 44.1% e Especificidade de 93.2%. O VPP foi de 68.2% e o VPN de 92.8%. O NLR apresentou uma AUC de 0,7 [0,607 – 0,798], Sensibilidade de 78.8% e Especificidade de 51.8%. O VPP foi de 78.8% e o VPN de 94.8%. Por fim, o HAPS apresentou para a predição de forma ligeira de PA uma AUC de 0,706 [0,623 – 0,790], Sensibilidade de 60.6% e Especificidade de 72.1%. O VPP foi de 87.3% e o VPN de 36.6%. Discussão / Conclusão. O BISAP, o NLR e o HAPS apresentaram-se como ferramentas úteis na estratificação e avaliação precoces do risco e prognóstico na PA, tendo o BISAP apresentado a maior capacidade preditiva entre três. Sociedade Portuguesa de Cirurgia2021-01-20info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.850https://doi.org/10.34635/rpc.850Revista Portuguesa de Cirurgia; No 49 (2020): Number 49 - December 2020; 42-47Revista Portuguesa de Cirurgia; No 49 (2020): Number 49 - December 2020; 42-472183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spcir.com/index.php/spcir/article/view/850https://revista.spcir.com/index.php/spcir/article/view/850/582Copyright (c) 2021 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessBorges, FilipeMiranda, JoanaSilva, SofiaCarvalho, NunoMatos Costa, Paulo2024-03-14T22:04:54Zoai:revista.spcir.com:article/850Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:45.794946Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION COMPARAÇÃO DO BISAP, NLR E HAPS NA PREVISÃO DA GRAVIDADE NA PANCREATITE AGUDA, SEGUNDO A REVISÃO DE 20 12 DA CLASSIFICAÇÃO DE ATLANTA |
title |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION |
spellingShingle |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION Borges, Filipe |
title_short |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION |
title_full |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION |
title_fullStr |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION |
title_full_unstemmed |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION |
title_sort |
COMPARISON OF BISAP, NLR AND HAPS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS, ACCORDING TO THE 2012 REVISION OF ATLANTA CLASSIFICATION |
author |
Borges, Filipe |
author_facet |
Borges, Filipe Miranda, Joana Silva, Sofia Carvalho, Nuno Matos Costa, Paulo |
author_role |
author |
author2 |
Miranda, Joana Silva, Sofia Carvalho, Nuno Matos Costa, Paulo |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Borges, Filipe Miranda, Joana Silva, Sofia Carvalho, Nuno Matos Costa, Paulo |
description |
Backgrond. Early risk stratification is crucial in Acute Pancreatitis (AP). The BedSide Index for Severity in Acute Pancreatitis (BISAP) allows risk stratification at the time of hospital admission through a five-variable analysis. Several inflammatory markers have shown prognostic value in AP. Amongst them the Neutrophil to Lymphocyte Ratio has the best predictive accuracy. The Harmless Acute Pancreatitis Score (HAPS) is used to predict mild AP. Our objective was to compare BISAP, NLR and HAPS as predictors of severity in acute pancreatitis. Material and Methods. A six-year (January 2014 – December 2019) retrospective analysis of a prospective database of all the patients admitted with the diagnosis of AP. Included variables: age, sex, BISAP score, NLR, HAPS score, length of stay, severity and mortality. Severity was defined according to 2012 revision of Atlanta classification. Accuracy of prediction was measured by the area under the receiver operating characteristic curve (AUC). Positive Predictive Value (PPV), Negative Predictive Value (NPV), Sensitivity and Specificity were also calculated. Results. Total of 284 cases; 121 male and 163 female; median age was 71 years [21 – 95]. 216 patients presented mild AP, 34 moderate and 34 severe AP; overall mortality was 4.2%. The BISAP AUC for prediction of severity was 0,86 [0,796 – 0,936]. Sensivity was 44.1% and specificity was 93.2%. PPV was 68.2% and NPV was 92.8%. The NLR AUC was 0,7 [0,607 – 0,798]. Sensivity was 78.8% and specificity was 51.8%. PPV was 78.8% and NPV was 94.8%. Finally, HAPS AUC for prediction of mild AP was 0,706 [0,623 – 0,790]. Sensitivity was 60.6% and specificity was 72.1%. PPV was 87.3% and NPV was 36.6%. Conclusion. BISAP, NLR and HAPS are valuable tools for an early risk stratification and prognosis evaluation in AP. The best calculated accuracy for the prediction of severity was for BISAP. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-20 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34635/rpc.850 https://doi.org/10.34635/rpc.850 |
url |
https://doi.org/10.34635/rpc.850 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/850 https://revista.spcir.com/index.php/spcir/article/view/850/582 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 49 (2020): Number 49 - December 2020; 42-47 Revista Portuguesa de Cirurgia; No 49 (2020): Number 49 - December 2020; 42-47 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799138182417088512 |