Early evaluations of BISAP plus C-reactive protein in predicting the severity of acute pancreatitis

Abstract

To explore the early evaluations of Bedside Index for Severity in Acute Pancreatitis (BISAP) plus C-reactive protein (CRP) in predicting the severity and prognosis of acute pancreatitis (AP). A total of 114 cases of AP at our hospital over the last 2 years were retrospectively analyzed. The levels of amylase, serum glucose, serum calcium, CRP and D-dimer in 24 hours were measured. According to the evaluation standard, the scores of BISAP, acute physiology and chronic health evaluation (APACHE II), Ranson and computed tomography severity index (CTSI) were obtained. Mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), severe acute pancreatitis (SAP), death toll and their proportion were compared in different BISAP scores. Correlation analyses were conducted for BISAP scores and laboratory indices, CRP and different scoring systems. We compared the evaluative value of BISAP plus CRP and other scoring systems in SAP. With rising BISAP scores, both severity and mortality increased in acute pancreatitis (χ(2) = 78.616, P < 0.01). BISAP scores were positively correlated with CRP, D-dimer and serum glucose (r = 0.451, 0.329, 0.241, P < 0.01) and negatively correlated with serum calcium ((r = -0.315, P < 0.01). CRP was positively correlated with APACHE-II, Ranson's, BISAP and CTSI scores (r = 0.407, 0.392, 0.451, 0.427, P < 0.001). When CRP was included into the BISAP scores, the area under the curve (AUC) of predicting SAP was 0.873 and the AUC of predicting death 0.909 so that BISAP score plus CRP had a good predictive value for the severity of AP and death. In clinical practice, the simple BISAP scoring system may predict the severity of AP. And BISAP score plus CRP has a better predictive value for AP.