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Comparison of CCI, BISAP and APACHE II Scoring Systems to Predict Severe Disease in Patients with Mild Acute Pancreatitis: A Retrospective Observational Study

Yıl 2022, , 460 - 469, 31.12.2022

Hakan Aydın , Fatih Doğanay , Mehmet Erdoğan , Halil Doğan , Attila Beştemir , Alpay Tuncar

https://doi.org/10.7197/cmj.1216327

Öz

Background: Early recognition and treatment of patients with acute pancreatitis (AP) is important to improve prognosis and increase survival. Many scoring systems have been developed to assess the prognosis and disease severity in AP. The aim of this study was to compare the effectiveness of the Charlson Comorbidity Index (CCI), Bedside Index for Severity in AP (BISAP), and Acute Physiology and Chronic Health Evaluation (APACHE II) scores in predicting 30-day mortality and the development of severe AP (SAP) in patients with mild AP (MAP).
Materials and Methods: This single-center, retrospective, and observational study was conducted with adult patients classified as MAP within 48 hours of arrival at the emergency department. Areas under the receiver operating characteristic curve (AUC) were calculated for each score to evaluate the effectiveness of the scores in predicting the development of SAP and 30-day mortality.
Results: A total of 1419 patients with MAP were included in the study between January 01, 2018 and April 01, 2022. In MAP patients, SAP development rate was 14.4%, and the 30-day mortality rate was 1.8%. The accuracy of CCI (AUC=0.797±0.015) in predicting the development of SAP was significantly higher than BISAP (AUC =0.736±0.019, p<0.001) and APACHE II (AUC =0.755±0.017, p=0.028) scores. The accuracy of CCI (AUC 0.797±0.040) in predicting 30-day mortality was similar to the BISAP score (AUC 0.790±0.041, p=0.844) and APACHE II score (AUC=0.762±0.042, p=0.417). There was no significant difference between the accuracy of BISAP and APACHE II scores in predicting the development of SAP (p= 0.196) and 30-day mortality (p=0.462).
Conclusion: The CCI is a scoring system as effective as BİSAP and APACHE 2 scores in predicting the development of SAP and 30-day mortality in patients with MAP in our study population.

Anahtar Kelimeler

Charlson Comorbidity Index APACHE II BISAP Severe Acute Pancreatitis Scoring Systems

Proje Numarası

Yok

Kaynakça

  • 1. Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013;144:1252–61.
  • 2. Rasch S, Pichlmeier E, Phillip V, et al. Prediction of outcome in acute pancreatitis by the qSOFA and the new ERAP score. Dig Dis Sci. 2021: 67(4);1371-8.
  • 3. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013;62:102-11.
  • 4. Vege SS, Gardner TB, Chari ST, et al. Low mortality and high morbidity in severe acute pancreatitis without organ failure: A case for revising the Atlanta classification to include “moderately severe acute pancreatitis” Am J Gastroenterol. 2009;104(3):710–15.
  • 5. Popa CC, Badiu DC, Rusu OC, et al. Mortality prognostic factors in acute pancreatitis. Journal of medicine and life, 2016;9(4):413.
  • 6. Szatmary P, Grammatikopoulos T, Cai W, et al. Acute Pancreatitis: Diagnosis and Treatment. Drugs. 2022;82(12):1251-76.
  • 7. Beger HG, Rau BM. Severe acute pancreatitis: clinical course and management. World J Gastroenterology 2007;13(38):5043–51.
  • 8. Erdogan MÖ, Hokenek NM. How to score acute pancreatitis in the emergency setting: five systems against ED-SAS. Signa Vitae, 2021;1:8.
  • 9. Yang L, Liu J, Xing Y, et al. Comparison of BISAP, Ranson, MCTSI, and APACHE II in predicting severity and prognoses of hyperlipidemic acute pancreatitis in Chinese patients. Gastroentero Res Pract 2016:1834256.
  • 10. Coluoglu I, Coluoglu E, Binicier HC,Binicier OB. The role of the BISAP score in predicting acute pancreatitis severity according to the revised Atlanta classification: a single tertiary care unit experience from Turkey. Acta Gastro-Enterologica Belgica, 2021;84(4):571-6.
  • 11. Harshit Kumar A, Singh Griwan M. 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) 2018;6:127-31.
  • 12. Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Rev Gastroenterol Mex.2007;72:257–85.
  • 13. Marshall JC, Cook DJ, Christou NV, et al. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23(10):1638–52.
  • 14. Charlson ME, Pompei P, Ales K, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of chronic diseases, 1987;40(5): 373-83.
  • 15. DeLong ER, DeLong DM & Clarke-Pearson DL. Comparing the Areas under Two or More Correlated Receiver Operating Characteristic Curves: a nonparametric approach. Biometrics 1988;44:837–45.
  • 16. Chatterjee R, Parab N, Sajjan B, & Nagar VS. Comparison of acute physiology and chronic health Evaluation II, modified computed tomography severity index, and bedside index for severity in acute pancreatitis score in predicting the severity of acute pancreatitis. Indian J Crit Care Med 2020;24:99–103.
  • 17. Chen L, Lu G, Zhou Q, Zhan Q. Evaluation of the BISAP score in predicting severity and prognoses of acute pancreatitis in Chinese patients. International surgery. 2013;98(1):6–12
  • 18. von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–9.
  • 19. Wilson C, Heath DI, Imrie CW. Prediction of outcome in acute pancreatitis: a comparative study of APACHE II, clinical assessment and multiple factor scoring systems. British Journal of Surgery, 1990;77(11):1260-4.
  • 20. Chatzicostas C, Roussomoustakaki M, Vlachonikolis IG, et al. Comparison of Ranson, APACHE II and APACHE III scoring systems in acute pancreatitis. Pancreas. 2002;25:331–5
  • 21. Perez A, Whang EE, Brooks DC, et al. Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis? Pancreas 2002;25:229–33.
  • 22. Le Mee J, Paye F, Sauvanet A, et al. Incidence and reversibility of organ failure in the course of sterile or infected necrotizing pancreatitis. Arch Surg 2001;136:1386–90.
  • 23. Lankisch PG, Warnecke B, Bruns D, et al. The APACHE II score is unreliable to diagnose necrotizing pancreatitis on admission to hospital. Pancreas 2002;24:217–22.
  • 24. Arvanitakis M, Dumonceau J-M, Albert J, et al. Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy 2018;50:524-46.
  • 25. Chandra S, Murali A, Bansal R, Agarwal D, Holm A. The Bedside index for severity in acute pancreatitis: a systematic review of prospective studies to determine predictive performance. J Community Hosp Intern Med Perspect. 2017;7(4):208-13.
  • 26. Cho YS, Kim HK, Jang EC, et al. Usefulness of the Bedside Index for severity in acute pancreatitis in the early prediction of severity and mortality in acute pancreatitis. Pancreas. 2013;42(3):483–7.
  • 27. Chen SM, Xiong GS, Wu SM. Is obesity an indicator of complications and mortality in acute pancreatitis? An updated meta-analysis. J Dig Dis. 2012;13:244–51.

Yıl 2022, , 460 - 469, 31.12.2022

Hakan Aydın , Fatih Doğanay , Mehmet Erdoğan , Halil Doğan , Attila Beştemir , Alpay Tuncar

https://doi.org/10.7197/cmj.1216327

Öz

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Kaynakça

  • 1. Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013;144:1252–61.
  • 2. Rasch S, Pichlmeier E, Phillip V, et al. Prediction of outcome in acute pancreatitis by the qSOFA and the new ERAP score. Dig Dis Sci. 2021: 67(4);1371-8.
  • 3. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013;62:102-11.
  • 4. Vege SS, Gardner TB, Chari ST, et al. Low mortality and high morbidity in severe acute pancreatitis without organ failure: A case for revising the Atlanta classification to include “moderately severe acute pancreatitis” Am J Gastroenterol. 2009;104(3):710–15.
  • 5. Popa CC, Badiu DC, Rusu OC, et al. Mortality prognostic factors in acute pancreatitis. Journal of medicine and life, 2016;9(4):413.
  • 6. Szatmary P, Grammatikopoulos T, Cai W, et al. Acute Pancreatitis: Diagnosis and Treatment. Drugs. 2022;82(12):1251-76.
  • 7. Beger HG, Rau BM. Severe acute pancreatitis: clinical course and management. World J Gastroenterology 2007;13(38):5043–51.
  • 8. Erdogan MÖ, Hokenek NM. How to score acute pancreatitis in the emergency setting: five systems against ED-SAS. Signa Vitae, 2021;1:8.
  • 9. Yang L, Liu J, Xing Y, et al. Comparison of BISAP, Ranson, MCTSI, and APACHE II in predicting severity and prognoses of hyperlipidemic acute pancreatitis in Chinese patients. Gastroentero Res Pract 2016:1834256.
  • 10. Coluoglu I, Coluoglu E, Binicier HC,Binicier OB. The role of the BISAP score in predicting acute pancreatitis severity according to the revised Atlanta classification: a single tertiary care unit experience from Turkey. Acta Gastro-Enterologica Belgica, 2021;84(4):571-6.
  • 11. Harshit Kumar A, Singh Griwan M. 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) 2018;6:127-31.
  • 12. Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Rev Gastroenterol Mex.2007;72:257–85.
  • 13. Marshall JC, Cook DJ, Christou NV, et al. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23(10):1638–52.
  • 14. Charlson ME, Pompei P, Ales K, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of chronic diseases, 1987;40(5): 373-83.
  • 15. DeLong ER, DeLong DM & Clarke-Pearson DL. Comparing the Areas under Two or More Correlated Receiver Operating Characteristic Curves: a nonparametric approach. Biometrics 1988;44:837–45.
  • 16. Chatterjee R, Parab N, Sajjan B, & Nagar VS. Comparison of acute physiology and chronic health Evaluation II, modified computed tomography severity index, and bedside index for severity in acute pancreatitis score in predicting the severity of acute pancreatitis. Indian J Crit Care Med 2020;24:99–103.
  • 17. Chen L, Lu G, Zhou Q, Zhan Q. Evaluation of the BISAP score in predicting severity and prognoses of acute pancreatitis in Chinese patients. International surgery. 2013;98(1):6–12
  • 18. von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–9.
  • 19. Wilson C, Heath DI, Imrie CW. Prediction of outcome in acute pancreatitis: a comparative study of APACHE II, clinical assessment and multiple factor scoring systems. British Journal of Surgery, 1990;77(11):1260-4.
  • 20. Chatzicostas C, Roussomoustakaki M, Vlachonikolis IG, et al. Comparison of Ranson, APACHE II and APACHE III scoring systems in acute pancreatitis. Pancreas. 2002;25:331–5
  • 21. Perez A, Whang EE, Brooks DC, et al. Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis? Pancreas 2002;25:229–33.
  • 22. Le Mee J, Paye F, Sauvanet A, et al. Incidence and reversibility of organ failure in the course of sterile or infected necrotizing pancreatitis. Arch Surg 2001;136:1386–90.
  • 23. Lankisch PG, Warnecke B, Bruns D, et al. The APACHE II score is unreliable to diagnose necrotizing pancreatitis on admission to hospital. Pancreas 2002;24:217–22.
  • 24. Arvanitakis M, Dumonceau J-M, Albert J, et al. Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy 2018;50:524-46.
  • 25. Chandra S, Murali A, Bansal R, Agarwal D, Holm A. The Bedside index for severity in acute pancreatitis: a systematic review of prospective studies to determine predictive performance. J Community Hosp Intern Med Perspect. 2017;7(4):208-13.
  • 26. Cho YS, Kim HK, Jang EC, et al. Usefulness of the Bedside Index for severity in acute pancreatitis in the early prediction of severity and mortality in acute pancreatitis. Pancreas. 2013;42(3):483–7.
  • 27. Chen SM, Xiong GS, Wu SM. Is obesity an indicator of complications and mortality in acute pancreatitis? An updated meta-analysis. J Dig Dis. 2012;13:244–51.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Cerrahi Tıp Bilimleri Araştırma Yazıları
Yazarlar

Hakan Aydın 0000-0003-3195-1805

Fatih Doğanay 0000-0003-4720-787X

Mehmet Erdoğan 0000-0001-7325-6646

Halil Doğan 0000-0003-4751-030X

Attila Beştemir 0000-0003-0986-9039

Alpay Tuncar 0000-0002-3889-819X

Proje Numarası Yok
Yayımlanma Tarihi 31 Aralık 2022
Kabul Tarihi 27 Aralık 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

AMA Aydın H, Doğanay F, Erdoğan M, Doğan H, Beştemir A, Tuncar A. Comparison of CCI, BISAP and APACHE II Scoring Systems to Predict Severe Disease in Patients with Mild Acute Pancreatitis: A Retrospective Observational Study. CMJ. Aralık 2022;44(4):460-469. doi:10.7197/cmj.1216327