Araştırma Makalesi
Yıl 2023,
Cilt: 48 Sayı: 3, 1096 - 1105, 30.09.2023
Öz
Amaç: Bu çalışmada acil serviste akut pankreatit tanısı alan hastalar, hastalık şiddeti ve prognoz göstergesi olan BAR ve BISAP skorları karşılaştırılarak değerlendirildi.
Gereç veYöntem: Retrospektif olarak planlanan bu gözlemsel çalışmaya 2016-2021 yılları arasında akut pankreatit tanısı alan 457 hasta dahil edildi. Hastaların laboratuvar verileri ve hesaplanan BİSAP skorları kaydedildi. Elde edilen tüm sonuçlar istatistiksel olarak değerlendirildi.
Bulgular: Hastalar BISAP skoruna göre sınıflandırıldı, 385 (%84,2) hasta akut pankreatit açısından düşük riskli iken, 72 (%15,8) hasta yüksek riskli idi. BİSAP kategorileri için BAR değerinin regresyon analizi yapılmıştır. BAR değeri arttıkça BİSAP yüksek risk değeri 38.339 kat arttı. BAR ve BİSAP değerlendirme kriterleri arasındaki duyarlılık oranı %68,67 (0,60-0,75) olarak bulundu ve BAR değerinin BİSAP skoru kadar hastalığın şiddeti ile güçlü bir şekilde ilişkili olduğu belirlendi.
Sonuçlar: Bu çalışma, BAR'ın yüksek riskli akut pankreatiti belirlemede BISAP skorları kadar etkili olduğunu göstermektedir.
Anahtar Kelimeler
Kaynakça
- Singer MV, Gyr K, Sarles H. Revised classification of pancreatitis: Report of the Second International Symposium on the Classification of Pancreatitis in Marseille, France. Gastroenterology. 1985;89:683-5.
- Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.
- Buter A, Imrie CW, Carter CR, Evans S, McKay CJ. The dynamic nature of early organ dysfunction determines the outcome of acute pancreatitis. Br J Surg. 2002;89:298-302.
- Al-Qahtani HH, Alam MKh, Waheed M. Comparison of harmless acute pancreatitis score with ranson's score in predicting the severity of acute pancreatitis. J Coll Physicians Surg Pak. 2017;27:75-9.
- Simchuk EJ, Traverso LW, Nukui Y, Kozarek RA. Computed tomography severity index is a predictor of outcomes for severe pancreatitis. Am J Surg. 2000;179:352-5.
- Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698-703.
- Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019;13:14-27.
- Shorr AF, Sun X, Johannes RS, Yaitanes A, Tabak YP. Validation of a novel risk score for severity of illness in acute exacerbations of COPD. Chest. 2011;140:1177–83.
- Faisst M, Wellner UF, Utzolino S, Hopt UT, Keck T. Elevated blood urea nitrogen is an independent risk factor of prolonged intensive care unit stay due to acute necrotizing pancreatitis. J Crit Care. 2010;25:105–11.
- Hong W, Lin S, Zippi M, Geng W, Stock S, Basharat Z et al. Serum albumin is independently associated with persistent organ failure in acute pancreatitis. Can J Gastroenterol Hepatol. 2017;14:124-35.
- Ryu S, Oh SK, Cho SU, You Y, Park JS, Min JH et al. Utility of the blood urea nitrogen to serum albumin ratio as a prognostic factor of mortality in aspiration pneumonia patients. Am J Emerg Med. 2021;43:175-9.
- Wang D, Yang J, Zhang J, Zhang S, Wang B, Wang R et al. Red cell distribution width predicts deaths in patients with acute pancreatitis. J Res Med Sci. 2015;20:424-8.
- Hagjer S, Kumar N. Evaluation of the BISAP scoring system in prognostication of acute pancreatitis–A prospective observational study. Int J Surg. 2018;54:76-81.
- Bardakçı O, Akdur G, Das M, Sıddıkoğlu D, Akdur O, Beyazit Y. Comparison of different risk stratification systems for prediction of acute pancreatitis severity in patients referred to the emergency department of a tertiary care hospital. Ulus Travma Acil Cerrahi Derg. 2022;28:967-73.
- Yılmaz EM, Kandemir A. Significance of red blood cell distribution width and C-reactive protein/albumin levels in predicting prognosis of acute pancreatitis. Ulus Travma Acil Cerrahi Derg. 2018;24:528-31.
- Mandalia A, Wamsteker EJ, DiMagno MJ. Recent advances in understanding and managing acute pancreatitis. F1000Res. 2018;7:F1000 Faculty Rev-959.
- Aronson D, Mittleman MA, Burger AJ. Elevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure. Am J Med. 2004;116:466-73.
- Ito A, Ishida T, Tokumasu H, Washio Y, Yamazaki A, Ito Y et al. Prognostic factors in hospitalized community-acquired pneumonia: a retrospective study of a prospective observational cohort. BMC Pulm Med. 2017;17:78.
- Cheng A, Hu L, Wang Y, Huang L, Zhao L, Zhang C et al. Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. Int J Antimicrob Agents. 2020;56:106110.
- Liu Q, Wang Y, Zhao X, Wang L, Liu F, Wang T et al. Diagnostic performance of a blood urea nitrogen to creatinine ratio-based nomogram for predicting in-hospital mortality in COVID-19 patients. Risk Manag Health Policy. 2021;14:117-28.
- Shao M, Li X, Liu F, Tian T, Luo J, Yang Y. Acute kidney injury is associated with severe infection and fatality in patients with COVID-19: A systematic review and meta-analysis of 40 studies and 24,527 patients. Pharmacol Res. 2020;161:105107.
- Pando E, Alberti P, Mata R, Gomez MJ, Vidal L, Cirera A et al. 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, 2021.
- Caraceni P, Domenicali M, Tovoli A, Napoli L, Ricci CS, Tufoni M. et al. Clinical indications for the albumin use: still a controversial issue. Eur J Intern Med. 2013;24:721-8.
- Gruys E, Toussaint MJM, Niewald TA,. Acute phase reaction and acute phase proteins. J Zhejiang Univ Sci, 2005;11:1045-56.
- González-Pacheco H, Amezcua-Guerra LM, Sandoval J, Martínez-Sánchez C, OrtizLeón XA, Peña-Cabral MA et al. Prognostic implications of serum albumin levels in patients with acute coronary syndromes. Am J Cardiol. 2017;119:951–8.
- Viasus D, Garcia-Vidal C, Simonetti A, Manresa F, Dorca J, Gudiol F et al. Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia. J Infect. 2013;66:415-23.
- Hong W, Lin S, Zippi M, Geng W, Stock S, Basharat Z et al. Serum albumin is independently associated with persistent organ failure in acute pancreatitis. Can J Gastroenterol Hepatol. 2017;2017:5297143.
- Ugajin M, Yamaki K, Iwamura N, Yagi T, Asano T. Blood urea nitrogen to serum albumin ratio independently predicts mortality and severity of community-acquired pneumonia. Int J Gen Med. 2012;5:583-9.
- Dundar ZD, Kucukceran K, Ayranci MK. Blood urea nitrogen to albumin ratio is a predictor of in-hospital mortality in older emergency department patients. Am J Emerg Med. 2021;46:349-54.
- Küçükceran K, Ayrancı MK, Girişgin AS, Koçak S, Dündar ZD. The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department. Am J Emerg Med. 2021;48:33-7
Yıl 2023,
Cilt: 48 Sayı: 3, 1096 - 1105, 30.09.2023
Öz
Purpose: This study evaluated patients diagnosed with acute pancreatitis in the emergency department by comparing the BUN/Albumin Ratio (BAR) and BISAP scores to indicate disease severity and prognosis.
Materials and Methods: 457 patients diagnosed with acute pancreatitis between 2016 and 2021 were included in this observational study, which was planned retrospectively. The laboratory data of the patients and the calculated BISAP scores were recorded.
Results: Patients were categorized according to the BISAP score; 385 (84.2%) patients were at low risk for acute pancreatitis, while 72 (15.8%) were at high risk. The AUC for BAR values was 0.757 (75.7%), and this was statistically significant for determining cutoff values, with a cutoff value of >4.60 (p<0.001). Regression analysis of the BAR value was performed for the BISAP categories. As the BAR value increased, the BISAP high-risk value increased 38,339 times. The sensitivity ratio between BAR and BISAP evaluation criteria was found to be 68.67% (0.60-0.75), and it was determined that the BAR value was as strongly correlated with the severity of the disease as the BISAP score.
Conclusion: This study shows that BAR is as effective as BISAP scores in determining high-risk acute pancreatitis.
Anahtar Kelimeler
BUN/albumın ratıo Emergency department acute pancreatitis BISAP
Kaynakça
- Singer MV, Gyr K, Sarles H. Revised classification of pancreatitis: Report of the Second International Symposium on the Classification of Pancreatitis in Marseille, France. Gastroenterology. 1985;89:683-5.
- Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.
- Buter A, Imrie CW, Carter CR, Evans S, McKay CJ. The dynamic nature of early organ dysfunction determines the outcome of acute pancreatitis. Br J Surg. 2002;89:298-302.
- Al-Qahtani HH, Alam MKh, Waheed M. Comparison of harmless acute pancreatitis score with ranson's score in predicting the severity of acute pancreatitis. J Coll Physicians Surg Pak. 2017;27:75-9.
- Simchuk EJ, Traverso LW, Nukui Y, Kozarek RA. Computed tomography severity index is a predictor of outcomes for severe pancreatitis. Am J Surg. 2000;179:352-5.
- Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698-703.
- Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019;13:14-27.
- Shorr AF, Sun X, Johannes RS, Yaitanes A, Tabak YP. Validation of a novel risk score for severity of illness in acute exacerbations of COPD. Chest. 2011;140:1177–83.
- Faisst M, Wellner UF, Utzolino S, Hopt UT, Keck T. Elevated blood urea nitrogen is an independent risk factor of prolonged intensive care unit stay due to acute necrotizing pancreatitis. J Crit Care. 2010;25:105–11.
- Hong W, Lin S, Zippi M, Geng W, Stock S, Basharat Z et al. Serum albumin is independently associated with persistent organ failure in acute pancreatitis. Can J Gastroenterol Hepatol. 2017;14:124-35.
- Ryu S, Oh SK, Cho SU, You Y, Park JS, Min JH et al. Utility of the blood urea nitrogen to serum albumin ratio as a prognostic factor of mortality in aspiration pneumonia patients. Am J Emerg Med. 2021;43:175-9.
- Wang D, Yang J, Zhang J, Zhang S, Wang B, Wang R et al. Red cell distribution width predicts deaths in patients with acute pancreatitis. J Res Med Sci. 2015;20:424-8.
- Hagjer S, Kumar N. Evaluation of the BISAP scoring system in prognostication of acute pancreatitis–A prospective observational study. Int J Surg. 2018;54:76-81.
- Bardakçı O, Akdur G, Das M, Sıddıkoğlu D, Akdur O, Beyazit Y. Comparison of different risk stratification systems for prediction of acute pancreatitis severity in patients referred to the emergency department of a tertiary care hospital. Ulus Travma Acil Cerrahi Derg. 2022;28:967-73.
- Yılmaz EM, Kandemir A. Significance of red blood cell distribution width and C-reactive protein/albumin levels in predicting prognosis of acute pancreatitis. Ulus Travma Acil Cerrahi Derg. 2018;24:528-31.
- Mandalia A, Wamsteker EJ, DiMagno MJ. Recent advances in understanding and managing acute pancreatitis. F1000Res. 2018;7:F1000 Faculty Rev-959.
- Aronson D, Mittleman MA, Burger AJ. Elevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure. Am J Med. 2004;116:466-73.
- Ito A, Ishida T, Tokumasu H, Washio Y, Yamazaki A, Ito Y et al. Prognostic factors in hospitalized community-acquired pneumonia: a retrospective study of a prospective observational cohort. BMC Pulm Med. 2017;17:78.
- Cheng A, Hu L, Wang Y, Huang L, Zhao L, Zhang C et al. Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. Int J Antimicrob Agents. 2020;56:106110.
- Liu Q, Wang Y, Zhao X, Wang L, Liu F, Wang T et al. Diagnostic performance of a blood urea nitrogen to creatinine ratio-based nomogram for predicting in-hospital mortality in COVID-19 patients. Risk Manag Health Policy. 2021;14:117-28.
- Shao M, Li X, Liu F, Tian T, Luo J, Yang Y. Acute kidney injury is associated with severe infection and fatality in patients with COVID-19: A systematic review and meta-analysis of 40 studies and 24,527 patients. Pharmacol Res. 2020;161:105107.
- Pando E, Alberti P, Mata R, Gomez MJ, Vidal L, Cirera A et al. 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, 2021.
- Caraceni P, Domenicali M, Tovoli A, Napoli L, Ricci CS, Tufoni M. et al. Clinical indications for the albumin use: still a controversial issue. Eur J Intern Med. 2013;24:721-8.
- Gruys E, Toussaint MJM, Niewald TA,. Acute phase reaction and acute phase proteins. J Zhejiang Univ Sci, 2005;11:1045-56.
- González-Pacheco H, Amezcua-Guerra LM, Sandoval J, Martínez-Sánchez C, OrtizLeón XA, Peña-Cabral MA et al. Prognostic implications of serum albumin levels in patients with acute coronary syndromes. Am J Cardiol. 2017;119:951–8.
- Viasus D, Garcia-Vidal C, Simonetti A, Manresa F, Dorca J, Gudiol F et al. Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia. J Infect. 2013;66:415-23.
- Hong W, Lin S, Zippi M, Geng W, Stock S, Basharat Z et al. Serum albumin is independently associated with persistent organ failure in acute pancreatitis. Can J Gastroenterol Hepatol. 2017;2017:5297143.
- Ugajin M, Yamaki K, Iwamura N, Yagi T, Asano T. Blood urea nitrogen to serum albumin ratio independently predicts mortality and severity of community-acquired pneumonia. Int J Gen Med. 2012;5:583-9.
- Dundar ZD, Kucukceran K, Ayranci MK. Blood urea nitrogen to albumin ratio is a predictor of in-hospital mortality in older emergency department patients. Am J Emerg Med. 2021;46:349-54.
- Küçükceran K, Ayrancı MK, Girişgin AS, Koçak S, Dündar ZD. The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department. Am J Emerg Med. 2021;48:33-7
Toplam 30 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Acil Tıp |
| Bölüm | Araştırma |
| Yazarlar | |
| Erken Görünüm Tarihi | 26 Eylül 2023 |
| Yayımlanma Tarihi | 30 Eylül 2023 |
| Kabul Tarihi | 19 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 48 Sayı: 3 |
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