Abstract
Background and Aims. This study evaluated the prognostic accuracy of BUN for severe acute pancreatitis (SAP) and in-hospital mortality (IHM) in terms of the best timing for BUN measurement and the optimal BUN cutoff points. Methods. BUN determinants at the time of admission and 24 hrs after hospital admission were recorded and analyzed statistically. The ability of BUN in predicting the SAP and the occurrence of IHM were assessed using the area under the receiver-operating characteristic (ROC) curve. Results. For SAP, AUC of BUN at admission and 24 hrs after hospital admission was 0.75 and 0.80, respectively. For IHM in acute pancreatitis, it was 0.86 at admission and 0.84 after 24 hrs of hospital admission, respectively. The optimal cutoff point of BUN 24 hrs after hospital admission for SAP and at admission for IHM was 8.3 mmol/L and 13.3 mmol/L, respectively. Conclusion. BUN determination after 24 hrs of hospital admission has high accuracy for prediction of SAP while BUN at initial admission has high accuracy for prediction of IHM.
Highlights
Acute pancreatitis is a common clinical condition with variation in severity [1]
The outcomes of the present study prove that (i) both the Blood urea nitrogen (BUN) at admission and that after 24 hrs of hospitalization were useful predictors of severe acute pancreatitis (SAP), with AUC of more than 0.7
There are a lot of grounds, based on which BUN has been selected as useful prognostic/predictor of AP in the literature
Summary
Acute pancreatitis (referred to hereafter as AP) is a common clinical condition with variation in severity [1]. SAP, representing a paradigm of sterile inflammatory disease, is initiated by acinar cell injurymediated local inflammation and progresses to the systemic inflammatory response syndrome, accompanied with inevitable multiple organ injury, and eventually leads to multiple organ dysfunction syndrome, which contributes to the main cause of morbidity and mortality in this condition [4]. This typical pathological course results in approximately 50% of clinical deaths within the first week [5]. BUN determination after 24 hrs of hospital admission has high accuracy for prediction of SAP while BUN at initial admission has high accuracy for prediction of IHM
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