scholarly journals Procalcitonin and BISAP score versus c-reactive protein and APACHE II score in early assessment of severity and outcome of acute pancreatitis

2012 ◽  
Vol 69 (5) ◽  
pp. 425-431 ◽  
Author(s):  
Mihailo Bezmarevic ◽  
Zoran Kostic ◽  
Miodrag Jovanovic ◽  
Sasa Mickovic ◽  
Darko Mirkovic ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Form ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Serum Concentrations ◽  
Key Factors ◽  
Early Assessment ◽  
Adequate Treatment ◽  
Reactive Protein ◽  
Score Apache

Background/Aim. Early assessment of severity and continuous monitoring of patients are the key factors for adequate treatment of acute pancreatitis (AP). The aim of this study was to determine the value of procalcitonin (PCT) and Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system as prognostic markers in early stages of AP with comparison to other established indicators such as Creactive protein (CRP) and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Methods. This prospective study included 51 patients (29 with severe AP). In the first 24 h of admission in all patients the APACHE II score and BISAP score, CRP and PCT serum concentrations were determined. The values of PCT serum concentrations and BISAP score were compared with values of CRP serum concentrations and APACHE II score, in relation to the severity and outcome of the disease. Results. Values of PCT, CRP, BISAP score and APACHE II score, measured at 24 h of admission, were significantly elevated in patients with severe form of the disease. In predicting severity of AP at 24 h of admission, sensitivity and specificity of the BISAP score were 74% and 59%, respectively, APACHE II score 89% and 69%, respectively, CRP 75% and 86%, respectively, and PCT 86% and 63%, respectively. It was found that PCT is highly significant predictor of the disease outcome (p < 0,001). Conclusion. In early assessment of AP severity, PCT has better predictive value than CRP, and similar to the APACHE II score. APACHE II score is a stronger predictor of the disease severity than BISAP score. PCT is a good predictor of AP outcome.

scholarly journals APACHE II score, C-reactive protein and Marshall score in acute pancreatitis. Association with admission at critical care unit. A cohort study

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e321-e322
Author(s):  
H. Losada Morales ◽  
A. Troncoso Trujillo ◽  
L. Burgos San Juan ◽  
J. Silva Abarca ◽  
L. Acencio Barrientos ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Critical Care ◽  
Cohort Study ◽  
Critical Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Marshall Score

scholarly journals Soluble B7-H5 Is a Novel Diagnostic, Severity, and Prognosis Marker in Acute Pancreatitis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ruoxin Xu ◽  
Ju Gong ◽  
Wei Chen ◽  
Yakang Jin ◽  
Jian Huang
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Severe Acute Pancreatitis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Prognosis Marker ◽  
Score Apache ◽  
Marshall Score ◽  
Pain Patients ◽  
Ranson Score

As an important ligand in T lymphocyte costimulatory pathways, B7-H5 is involved deeply in the immune response in various diseases. However, its clinical usefulness as an early indicator in acute pancreatitis (AP) remains unclear. In this study, the levels of sB7-H5 and cytokines in plasma samples of 75 AP patients, 20 abdominal pain patients without AP, and 20 healthy volunteers were determined. Then, the correlation of sB7-H5 and clinical features, cytokines, the Ranson score, APACHE II score, Marshall score, and BISAP score was analysed, and the value of sB7-H5 for diagnostic, severity, and prognosis of AP was evaluated. We found that the levels of sB7-H5 were specifically upregulated in AP patients. Receiver operating characteristic (ROC) analysis revealed that sB7-H5 can identify AP patients from healthy or abdominal pain patients with 78.9% or 86.4% sensitivity and 93.3% or 90.0% specificity. Further analysis showed that the levels of sB7-H5 were significantly correlated with WBC ( p = 0.004 ), GLU ( p = 0.008 ), LDH ( p < 0.001 ), Ca2+ ( p = 0.006 ), AST ( p = 0.009 ), PLT ( p = 0.041 ), IL-6 ( p < 0.001 ), IL-10 ( p < 0.001 ), and TNF-α ( p < 0.001 ). And levels of sB7-H5 were gradually increased among patients with mildly acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). It can distinguish the severity of AP with good sensitivity and specificity. Moreover, when dividing the patients into two groups according to the median level of sB7-H5, the local complication and length of stay of low levels of the sB7-H5 group were significantly less than those in high levels of the sB7-H5 group. And the levels of sB7-H5 in AP patients were significantly correlated with the Ranson score ( p < 0.001 ), APACHE II score ( p < 0.001 ), Marshall score ( p < 0.001 ), and BISAP score ( p < 0.001 ). The AUCs of assessing local complications of sB7-H5 at day 1 and day 3 were 0.704 ( p = 0.0024 ) and 0.727 ( p = 0.0373 ). These results showed the potential value of sB7-H5 as a diagnostic, severity, and prognosis marker of AP.

scholarly journals Dynamic Changes in Plasma Mitochondrial DNA Concentration in Patients with Severe Acute Pancreatitis

2020 ◽  
Author(s):  
Zepeng Duan ◽  
Yujing Wang ◽  
Hua Ling ◽  
Qiong Li ◽  
Xingui Dai
Keyword(s):  
Acute Pancreatitis ◽  
Mitochondrial Dna ◽  
Severe Acute Pancreatitis ◽  
Sofa Score ◽  
Early Stage ◽  
Dynamic Change ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Reactive Protein ◽  
Failure Assessment

Abstract Background: The elevated plasma mitochondrial DNA (mtDNA) is associated with prognosis in patients with severe acute pancreatitis (SAP). However, it is not clear that the dynamic process of plasma mtDNA during the early stage of SAP and the correction between mtDNA and clinical features.Methods: Twenty-six eligible patients with SAP in the general intensive care unit of our institution were enrolled in this study. The mtDNA concentration were assessed at admission and on days 3, 5, and 7.Results: The mtDNA concentration of the patients with SAP was elevated at each time point compared with that in the healthy controls. The mtDNA levels increased rapidly, peaking on day 3 after admission, and began to decrease on day 5. The trend remained statistically consistent among the acute physiology and chronic health evaluation (APACHE II) score, the sequential organ failure assessment (SOFA) score, C-reactive protein (CRP) levels and mtDNA levels. Contrastingly, the changes were not statistically consistent among the procalcitonin (PCT), calciumion (Ca2+) and mtDNA concentrations. The mtDNA level correlated significantly with the APACHE II score, SOFA score, and Ranson score, but not with the CRP, PCT, and Ca2+ concentrations. Conclusions: The dynamic change of plasma mtDNA correlated significantly with SAP development. The elevated mtDNA levels could be used as a biomarker for the early stage of SAP.Trial registration: NCT: 04079777. Registered 4 September 2019 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00096E5&selectaction=Edit&uid=U0002O5I&ts=2&cx=-e6bci8

scholarly journals 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

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Elizabeth Pando ◽  
Piero Alberti ◽  
Rodrigo Mata ◽  
María José Gomez ◽  
Laura Vidal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Observational Study ◽  
Predictive Accuracy ◽  
Multiorgan Failure ◽  
Area Under The Curve ◽  
Apache Ii ◽  
Operating Characteristics ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Score Apache

Background. Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II), as well as other laboratory tests such as haematocrit and its variations over 24 h and C-reactive protein, in order to determine the most accurate test for predicting mortality and severity outcomes in AP. Methods. Clinical data of 410 AP patients, prospectively enrolled for study at our institution, were analyzed. We define AP according to Atlanta classification (AC) 2012. The laboratory test’s predictive accuracy was measured using area-under-the-curve receiver-operating characteristics (AUC) analysis and sensitivity and specificity tests. Results. Rise in BUN was the only score related to mortality on the multivariate analysis ( p = 0.000 , OR: 12.7; CI 95%: 4.2−16.6). On the comparative analysis of AUC, the rise in BUN was an accurate test in predicting mortality (AUC: 0.842) and persisting multiorgan failure (AUC: 0.828), similar to the BISAP score (AUC: 0.836 and 0.850) and APACHE-II (AUC: 0.756 and 0.741). The BISAP score outperformed both APACHE-II and rise in BUN at 24 hours in predicting severe AP (AUC: 0.873 vs. 0.761 and 0.756, respectively). Conclusion. Rise in BUN at 24 hours is a quick and reliable test in predicting mortality and persisting multiorgan failure in AP patients.

scholarly journals D-dimer levels in predicting the severity of acute pancreatitis

2017 ◽  
Vol 4 (12) ◽  
pp. 3993
Author(s):  
Anil Kumar ◽  
Ranjith Kothagattu
Keyword(s):  
Acute Pancreatitis ◽  
Prognostic Marker ◽  
Clinical Parameter ◽  
Multiple Organ ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Reactive Protein ◽  
Failure Assessment ◽  
The Mean ◽  
D Dimer

Background:Coagulative disorder is known to occur in the early phase of acute pancreatitis. (AP) and D-dimer is a commonly used clinical parameter of haemostasis. The aim of this study was to assess the value of the plasma D-dimer level as a marker of severity in the 1.3.5 days after admission in patients with Acute pancreatitis.Methods: From September 2015 to September 2017, 60 patients admitted for AP were included in this observational study. The D-dimer level was measured during days 1,3,5 after admission and the acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, and other clinical parameters were recorded at the same time. The maximum and the mean D-dimer values were used for analysis and compared with other prognostic factors of AP.Results:Both the maximum and mean levels of D-dimer were significantly different between patients with and without clinical variables such as multiple-organ dysfunction syndrome (MODS), need for surgical intervention, and the mortality. Additionally, the D-dimer level correlated well with two usual markers of AP severity-the APACHE II score and the C-reactive protein level. Conclusion D-dimer measurement is a useful, easy, and inexpensive early prognostic marker of the evolution and complications of AP.Conclusions:D-dimer measurement is a useful, easy, and inexpensive early prognostic marker of the evolution and complications of SAP.

scholarly journals Comparison of Multifactor Vs Independent Marker in Predicting Severity of Acute Pancreatitis

2020 ◽  
Vol 3 (1) ◽  
pp. 136-141
Author(s):  
Vijaykumar C Bada
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Pmn Elastase ◽  
Severe Pancreatitis ◽  
Poor Predictor ◽  
Score Apache ◽  
Pmn Élastase ◽  
Independent Marker

Background: Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. This study was conducted to compare the multifactor vs independent marker in predicting the severity of acute pancreatitis. Subjects and Methods: The present study comprised    of 50 patients of acute pancreatitis. In all patients, reactive protein (CRP), Interleukin-6 (IL-6), PMN-Elastase (PMN-E), Procalcitonin (PCT), RANSON”s score, GLASGOW score, APACHE-II score, APACHE-O score and Balthazar’s CTSI score was recorded. Results: There were 45 males and 5 females in the study. There were 12 (22.64%) obese patients in this study. The age of the patients was a significant indicator    to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age was a poor predictor       of the severity of acute pancreatitis. Obesity of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age is a poor predictor of the severity of acute pancreatitis. Organ failure at admission is more likely to reflect severe cases, it is found to be a poor predictor of severity in acute pancreatitis. The mean CTSI score in the study was 3.57 (SD 2.64), with a median of 2 and ranged from 1 to 10. It was higher in severe pancreatitis and a CTSI score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis. Conclusion: The authors found that overall, CRP was the best predictor, followed by IL-6, CTSI score, PCT, Glasgow, Ranson’s and APACHE-II. PMN-Elastase, Age, obesity and organ failure at admission are poor predictors of severity of acute pancreatitis.

Plasma ADAMTS13 Activity Markedly Decreases in Patients with Severe Acute Pancreatitis: Its Potential Role on the Development of Multiorgan Failure.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2160-2160
Author(s):  
Chie Morioka ◽  
Masahito Uemura ◽  
Tomomi Matsuyama ◽  
Masanori Matsumoto ◽  
Seiji Kato ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Healthy Subjects ◽  
Potential Role ◽  
Multiorgan Failure ◽  
Common Bile Duct Stones ◽  
Severe Form ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Adamts13 Activity

Abstract Background: A severe form of acute pancreatitis, severe acute pancreatitis (SAP), frequently develops pancreatitis-associated multiorgan failure (MOF) followed by systemic microcirculatory disturbance with a high mortality. ADAMTS13 has been focused on the occurrence of thrombotic thrombocytopenic purpura (TTP). TTP has been reported to cause acute pancreatitis in a few percents, and recent study indicates that some acute pancreatitis may be a triggering event for TTP. We sequentially determined plasma ADAMTS13 activity (ADAMTS13:AC) and its related parameters in patients with SAP, and thereby, tried to explore their potential role on the development of MOF. Methods: Subjects studied were 13 patients with SAP, who were admitted into the department of emergency and critical care medicine of our hospital. The etiology was alcohol in 7, idiopathic in 3, common bile duct stones in 2, and post endoscopic retrograde cholangiopancreatography in 1. Eleven patients were survivors and two were non-survivors. Two of 4 patients with MOF were non-survivors. The severity was scored according to APACHE-II system. ADAMTS13:AC was determined using a commercially available ADAMTS13-act-ELISA (Kainos Inc., Tokyo). Plasma levels of VWF antigen (VWF:AG), interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis-α (TNF-α) were measured by ELISA. Unusually large VWF multimer (UL-VWFM) was analyzed by a vertical SDS -1.0% agarose gel electrophoresis system. Results: ADAMTS13:AC significantly decreased at day 1 (mean 39%, p<0.001) and at day 2 (33%, p<0.001) as compared to healthy subjects (99%). The activity, thereafter, gradually recovered (49% at day 5, 58% at day 7, and 70% at day 10) in survivors, whereas in non-survivors, it decreased from 22% at day 1 to 10% at day 2 in one and showed 15% at day 1 in another. The inhibitor against ADAMTS13 was not detected. The VWF:AG increased to 402% at day 1 (p<0.001) and 333% at day 2 (p<0.001) as compared to healthy subjects (100%), and the value, thereafter, remained high (395% at day 5, 428% at day 7, and 382% at day 10). The UL-VWFM could be detected in 7 cases for 3 to 35 days immediately after admission. On admission, patients with detectable UL-VWFM tended to be lower ADAMTS13:AC and higher VWF:Ag than those without, resulting in higher VWF/ADAMTS13 ratio (19.9 vs. 8.9, p<0.01). Patients with MOF showed lower ADAMTS13:AC (20% vs. 40%, p<0.05) and higher VWF:Ag (448% vs. 391%, p<0.05) than those without, resulting in higher VWF/ADAMTS13 ratio (22.9 vs. 11.2, p<0.02). The concentrations of IL-6, IL-8, and TNFα increased, and ADAMTS13:AC correlated with those of IL-6 (r= − 0.51, p<0.05) and IL-8 (r= − 0.66, p<0.02). Furthermore, ADAMTS13:AC negatively correlated with APACHE-II score (r= − 0.67, p<0.02). Conclusion: Markedly decreased ADAMTS13:AC together with increased amounts of UL-VWFM was closely related to the severity of pancreatitis, an intense systemic inflammatory response, and prognosis in patients with SAP. These results indicate that the imbalance between the enzyme and its substrate may involve in the development of acute pancreatitis and subsequent MOF through enhanced thrombogenesis.

Sign in / Sign up

Export Citation Format

Share Document