Introduction: Acute pancreatitis is an acute inflammation of
the prior normal pancreas. Gallstones are its leading cause, followed by
alcohol; other etiological factors are hyperlipidemia, hereditary,
hypercalcemia and post ERCP, etc. Its pathogenesis involves the activation of
intrapancreatic digestive enzymes and the injury of acinar cells. Many scoring
systems are available to assess the severity of acute pancreatitis, e.g.,
Ranson’s criteria, Glasgow score index, APACHE II and CTSI, but they have
important limitations. BISAP score is a valuable tool in predicting severe
Acute Pancreatitis in the early hours. BISAP score appears cheap, quick, and
simple and hence, we conducted this study.
Material and Methods: This prospective observational study
was carried out in 83 patients at SGT Medical College, Gurugram, India from
September 2018 to March 2021. Patients with an established diagnosis of acute
pancreatitis as per the revised Atlanta classification and definition by the
International Census 2012 were included in the study. BISAP scores were
calculated from laboratory values and radiological findings.
Results: In our patients with BISAP scores of 0, 1 and 2,
there was no organ failure or mortality. At a score of 3, there was 1 (07.1%)
organ failure and 1 (07.1%) mortality. At a score of 4, 4 (80.0%) patients had
organ failure and 1(20.0%) patient died. We observed that the higher the BISAP
score, the higher the percentage of severity, necrosis, organ failure,
mortality and hospital stay. Our study revealed that with the cutoff value set
at 3, the BISAP score has 39.6% sensitivity, 92.8% specificity, 60.3% PPV and
84.7% NPV.
Conclusion: Our study recommends that at the time of
admission, if the BISAP score is low, our worry is less, if the BISAP score is
high, we should counsel the patient and attendants about possible severity,
necrosis, organ failure and mortality in acute pancreatitis. Patients should be
meticulously managed. The present study concludes the increased accuracy of the
BISAP score for risk stratification.
Author(s) Details
Dr. Kanwar Singh Goel (Professor & Head), M.S.
(General Surgery)
Department of General Surgery, SGT Medical College, SGT
University, Budhera, Gurugram, Haryana, India.
Dr. Nikhil Goel (Associate Professor and HOD)
Department of Psychiatry, Shaheed Hasan Khan Mewati Government Medical College,
Nuh, India.
Dr. Sapna
Singla (Assistant Professor)
Department of Pathology, Shaheed Hasan Khan Mewati
Government Medical College, Nuh, India.
Please see the book here :- https://doi.org/10.9734/bpi/dhrni/v1/1247
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