Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)

Abstract

Background: In recent years, the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing. It is important for clinicians to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP. Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients. Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score. Results There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC), Hospitalization days, Fatty liver and Local complications between two groups. However, there are no statistical differences(P>0.05) in Gender, Age,Serum amylase, Alanine aminotransferase(ALT), Aspertate aminotransferase(AST), Hypertension, Type2 diabetes and Hyperuricemia. The Area Under the Curve(AUC) of BISAP andMCTSI in predicting the severity of HLAP respectively were 0.89 0.78, sensitivity were 73.5% 79.4%, specificity were95.5% 60.2%, positive predictive value(PPV) were 80.6% 33.8%, negative predictive value(NPV) were 93.4% 92.0%. Furthermore, the AUC respectively were 0.73 0.87, sensitivity were 37.5% 90.1%, specificity were 93.2% 78.6%, PPV were 77.4% 72.5%, NPV were 70.6% 93.1% in predictionig local complications. Conclusion Compared to MCTSI score, BISAP score may be a better prognostic scoring system for predicting the severity of HLAP in view of accuracy and easiness.