Study of BISAP Scoring System, Ranson’s Scoring System and C-Reactive Protein Level as Predictors of Clinical Outcome in Acute Pancreatitis

Abstract

BACKGROUND This study was conducted to compare BISAP scoring system, Ranson’s score and CRP levels in predicting the clinical outcome in acute pancreatitis and for early detection of severity and organ failure in acute pancreatitis. METHODS This study was an observational longitudinal analytical study conducted among patients admitted with diagnosis of acute pancreatitis, in Father Muller Medical College Hospital, Mangalore, from November 2016 to March 2018. The study was started after obtaining ethical clearance from the institution’s ethical clearance committee. All patients diagnosed with acute pancreatitis between the age 20 and 60 years were included in the study. RESULTS Comparison of serum CRP levels between the Atlanta classified groups shows that severe group has the maximum value of 340.966 and mild has the minimum value of 55.38. This difference is statistically significant with a test value of 16.543 and a P value of < 0.001. On comparison of the test group, Ranson’s score with the BISAP score, the test group had a sensitivity of 89.3 % and specificity of 77.3 %. CONCLUSIONS The study has demonstrated the concordance between Ranson’s score, BISAP score and serum CRP level as predictors of clinical outcome in acute pancreatitis. KEY WORDS Acute Pancreatitis, Clinical Outcome, C Reactive Protein, Scoring Systems.

Comparative study between Ranson's scoring system and C reactive protein analysis in predicting the severity of acute pancreatitis

“…Acute pancreatitis is an inflammatory process which occurs in a normal organ and which is diagnosed generally by acute abdominal pain associated with a related increase in serum amylase and lipase concentration levels. 1,2 Over the years, many biomarkers and scoring systems have been used to assess the severity of the disease process. Scoring systems such as CRP, Apache system, Ranson's scoring system which assess multiple parameters have been used.…”

“…It is an important organ whose role was understood over the period of time and also the pathophysiology helped us elicit the signs and symptoms associated with the disease process.Acute pancreatitis is a self-limiting disease process which when diagnosed at the primary stages helps us manage the condition with utmost care, however in severe cases it has been deemed to be one of the most common lethal conditions. 1,2 Assessment of the severity of the disease process, many scoring systems have been proposed and in action since 1974. The ideal scoring system should be easy to apply, flawless and be capable of predicting the severity of the disease process.…”

“…It's production is induced by release of IL-1 and IL-6, several studies evaluated this marker as predictor for severity of acute pancreatitis, when measured at 24, 48 and 72 hours after admission and employed variable cutoff level to assess the severity of acute pancreatitis. 1,3 Here in this study, we are considering Ranson's scoring systems and CRP for analysis and comparing their values to assess the severity of acute pancreatitis and hence taking decision in the management and prognosis of the disease.…”