Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study
Background. Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II)...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2021/6643595 |
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| author | Elizabeth Pando Piero Alberti Rodrigo Mata María José Gomez Laura Vidal Arturo Cirera Cristina Dopazo Laia Blanco Concepción Gomez Mireia Caralt Joaquim Balsells Ramón Charco |
| author_facet | Elizabeth Pando Piero Alberti Rodrigo Mata María José Gomez Laura Vidal Arturo Cirera Cristina Dopazo Laia Blanco Concepción Gomez Mireia Caralt Joaquim Balsells Ramón Charco |
| author_sort | Elizabeth Pando |
| collection | DOAJ |
| description | Background. Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II), as well as other laboratory tests such as haematocrit and its variations over 24 h and C-reactive protein, in order to determine the most accurate test for predicting mortality and severity outcomes in AP. Methods. Clinical data of 410 AP patients, prospectively enrolled for study at our institution, were analyzed. We define AP according to Atlanta classification (AC) 2012. The laboratory test’s predictive accuracy was measured using area-under-the-curve receiver-operating characteristics (AUC) analysis and sensitivity and specificity tests. Results. Rise in BUN was the only score related to mortality on the multivariate analysis (p=0.000, OR: 12.7; CI 95%: 4.2−16.6). On the comparative analysis of AUC, the rise in BUN was an accurate test in predicting mortality (AUC: 0.842) and persisting multiorgan failure (AUC: 0.828), similar to the BISAP score (AUC: 0.836 and 0.850) and APACHE-II (AUC: 0.756 and 0.741). The BISAP score outperformed both APACHE-II and rise in BUN at 24 hours in predicting severe AP (AUC: 0.873 vs. 0.761 and 0.756, respectively). Conclusion. Rise in BUN at 24 hours is a quick and reliable test in predicting mortality and persisting multiorgan failure in AP patients. |
| format | Article |
| id | doaj-art-7578ada381a947ca8ea8ba8e66ac3a42 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-7578ada381a947ca8ea8ba8e66ac3a422025-02-03T00:58:47ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972021-01-01202110.1155/2021/66435956643595Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational StudyElizabeth Pando0Piero Alberti1Rodrigo Mata2María José Gomez3Laura Vidal4Arturo Cirera5Cristina Dopazo6Laia Blanco7Concepción Gomez8Mireia Caralt9Joaquim Balsells10Ramón Charco11Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall D’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainBackground. Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II), as well as other laboratory tests such as haematocrit and its variations over 24 h and C-reactive protein, in order to determine the most accurate test for predicting mortality and severity outcomes in AP. Methods. Clinical data of 410 AP patients, prospectively enrolled for study at our institution, were analyzed. We define AP according to Atlanta classification (AC) 2012. The laboratory test’s predictive accuracy was measured using area-under-the-curve receiver-operating characteristics (AUC) analysis and sensitivity and specificity tests. Results. Rise in BUN was the only score related to mortality on the multivariate analysis (p=0.000, OR: 12.7; CI 95%: 4.2−16.6). On the comparative analysis of AUC, the rise in BUN was an accurate test in predicting mortality (AUC: 0.842) and persisting multiorgan failure (AUC: 0.828), similar to the BISAP score (AUC: 0.836 and 0.850) and APACHE-II (AUC: 0.756 and 0.741). The BISAP score outperformed both APACHE-II and rise in BUN at 24 hours in predicting severe AP (AUC: 0.873 vs. 0.761 and 0.756, respectively). Conclusion. Rise in BUN at 24 hours is a quick and reliable test in predicting mortality and persisting multiorgan failure in AP patients.http://dx.doi.org/10.1155/2021/6643595 |
| spellingShingle | Elizabeth Pando Piero Alberti Rodrigo Mata María José Gomez Laura Vidal Arturo Cirera Cristina Dopazo Laia Blanco Concepción Gomez Mireia Caralt Joaquim Balsells Ramón Charco Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study Canadian Journal of Gastroenterology and Hepatology |
| title | Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study |
| title_full | Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study |
| title_fullStr | Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study |
| title_full_unstemmed | Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study |
| title_short | Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study |
| title_sort | early changes in blood urea nitrogen bun can predict mortality in acute pancreatitis comparative study between bisap score apache ii and other laboratory markers a prospective observational study |
| url | http://dx.doi.org/10.1155/2021/6643595 |
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