VALUATION OF THE IMPROVED BALTHAZAR SCORE WITH IMPROVED ATLANTA AND BISAP SCORE IN THE PROGNOSIS OF SEVERITY OF ACUTE PANCREATITIS
Main Article Content
Abstract
Background: Severe acute pancreatitis (AP) is a significant clinical problem which is associated with a high mortality at 12 - 30%. To predict the severity and mortality of (AP) multiple clinical, laboratory, and imaging - based scoring systems are available. A number of prognostic scores based on contrast - enhanced computed tomography results have been developed to help distinguish cases at risk of severe presentation and increased probability of complications (most popular - Balthazar score). Objectives: To determine of improved Balthzar score with improved Atlanta and BISAP in prognosis of severity of acute pancreatitis at Ca Mau General Hospital from 2019 to 2020. Materials and methods: A cross - sectional descriptive study of 50 patients presenting with AP was admitted at Department of Internal Gastroenterology in Ca Mau General Hospital from February 2019 to August 2020. Results: Of the 50 patients, 22% patients developed severe acute pancreatitis (SAP). The area under the curves (AUC) of improved Atlanta, BISAP and improved Balthazar for predicting serverity and mortality in AP were (0.927; 0.893; 0.965). The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) of improved Atlanta, BISAP and improved Balthazar score, with a cut-off of 3 in predicting SAP, were (100%; 82%; 61%; 100%) and (90%; 82%; 59%; 97%) and (100%; 74%; 52%;100%). Conclusions: Improved Balthazar scale score was a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who were at risk of developing pancreatic and/or peripancreatic necrosis already on the first day of the onset of symptoms and could be used for treatment planning and monitoring of therapy of acute pancreatitis.
Keywords
CECT: Contrast - enhanced computed tomography, acute pancreatitis
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Trần Xuân Linh (2014), Áp dụng tiêu chuẩn atlanta hiệu chỉnh năm 2012 trong tiên lượng viêm tụy cấp, Luận văn chuyên khoa cấp II, Trường Đại Học Y Khoa Phạm Ngọc Thạch, tr.79
3. Trần Thị Tuyết Ly (2018), Nghiên cứu đặc điểm lâm sàng, cận lâm sàng, đánh giá kết quả điều trị và ứng dụng thang điểm BISAP trong tiên lượng sớm độ nặng của viêm tuỵ cấp tại bệnh viện đa khoa trung ương Cần Thơ, Tạp chí Y Dược Học Cần Thơ, 16, tr. 07.
4. Trần Thanh Phong (2019), Nghiên cứu đặc điểm lâm sàng, cận lâm sàng, một số yếu tố liên quan đến mức độ nặng và đánh giá kết quả điều trị viêm tuỵ cấp do tăng triglyceride tại bệnh viện đa khoa trung ương Cần Thơ, Tạp chí Y Dược Học Cần Thơ, 20, tr. 07.
5. Abu-El-Haija M, Kumar S, Quiros JA, Balakrishnan K, Barth B, Bitton S, Eisses JF, Foglio EJ, Fox V, Francis D, Freeman AJ, Gonska T, Grover AS, Husain SZ, Kumar R, Lapsia S,
Lin T, Liu QY, Maqbool A, Sellers ZM, Szabo F, Uc A, Werlin SL, Morinville VD (2018), Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee. J. Pediatr. Gastroenterol. Nutr. 66(1), pp. 159-176.
6. Balthazar E. J, Robinson D. L, Megibow A. J, Ranson J. H (1990), Acute pancreatitis: value of CT in establishing prognosis, Radiology, 174, (2), pp. 331-6.
7. Banks P. A, T. L. Bollen, C. Dervenis, H. G. Gooszen, C. D. Johnson, M. G. Sarr, G. G. Tsiotos, S. S. Vege (2013), Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus, Gut, 62, (1), pp. 102-111.
8. Dellinger E P, C. E. Forsmark, P. Layer, P. Lévy, E. Maraví-Poma, M. S. Petrov, T. Shimosegawa, A. K. Siriwardena, G. Uomo, D. C. Whitcomb, J. A. Windsor (2012), Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation, Ann Surg, 256, (6), pp. 875-80.
9. Kumar A H, M. Singh Griwan (2018), A comparison of APACHE II, BISAP, Ranson's score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification, Gastroenterol Rep (Oxf), 6, (2), pp. 127-131.
10. Mikó A, Vigh É, Mátrai P (2019), Computed Tomography Severity Index vs. Other Indices in the Prediction of Severity and Mortality in Acute Pancreatitis: A Predictive Accuracy Meta-analysis, Front Physiol, 10, pp. 1002.
11. Pieńkowska J, Gwoździewicz K, Skrobisz-Balandowska K, Marek I, Kostro J, Szurowska E, Studniarek M (2016), Perfusion-CT--Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?, PLoS One, 11, (1), e0146965.
12. Pongprasobchai S, P. Vibhatavata, P. Apisarnthanarak (2017), Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification, Gastroenterol Res Pract, e. 3525349.
13. Shaikh R, Sabiha Zaheer 3 Nasreen Naz 2, Zahida Qadri 4, Aliya Khan 5, Hina Rana 6 (2018), Role of Modified CT Severity Index in Assessment of Acute Pancreatitis at Tertiary Care Hospital, Severity Index in assessment of Acute pancreatitis in tertiary care Hospital. JIMDC. 47(3), pp. 189-19,
14. Valverde-Lopez F, Wilcox C. M, Redondo-Cerezo E (2018), Evaluation and management of acute pancreatitis in Spain, Gastroenterol Hepatol, 41, (10), pp. 618-628.
15. Wu B. U, Johannes R. S, Tabak Y Sun X, Conwell D. L, Banks P. A (2008), The early prediction of mortality in acute pancreatitis: a large population-based study, Gut, 57, (12), pp. 1698-703.