title: [Bisap-O: obesity included in score BISAP to improve prediction of severity in acute pancreatitis].
abstract: BACKGROUND
  Most patients with acute pancreatitis exhibits a self-limiting clinical course and relatively free of major complications. Several scores have been created with the intention of achieving adequate and early predict the severity of pancreatitis in order to reduce this mortality. BISAP score was validated in 2008 as a predictor of mortality for acute pancreatitis, obesity is an independent risk factor that increases the risk of severity in patients with acute pancreatitis.The aim of this study is to determine whether obesity BISAP added a score improves prediction of severity in patients with acute pancreatitis.
  
  
  METHODS
  This study was conducted in Daniel Alcides Carrión Hospital, Lima, Peru. The patient data were collected in the Emergency Service, it was a cross-sectional retrospective study, between January 2009 and June 2010.
  
  
  RESULTS
  We evaluated a total of 99 patients with acute pancreatitis. Etiology of the 99 were biliary pancreatitis. Only 2 ended in death (2%). Most cases occurred in female patients 77/22 (77.8%). Sixteen of the 99 patients (16%) were considered severe acute pancreatitis. 90% (89/99) had a BISAP <3, 10% a BISAP ≥ 3, fifteen of the 99 patients had a BISAP-O> 3, of them 12 were actually considered a severe pancreatitis. Of 16 patients with severe pancreatitis, 14 patients had a BMI>25. (P = 0.03, OR = 4.39). BISAP-O has a sensitivity, specificity, PPV and NPV of 75%, 96.4%, 80% and 95.2% respectively, with an accuracy of 92.3%. The area under the curve for BISAP-O was 0.94 (95% CI 0.89 to 0.99). There was no difference when compared with the other studied scores (p = 0.45).
  
  
  CONCLUSIONS
  BISAP The score is a simple method that can be used to predict the severity of acute pancreatitis. Obesity associated BISAP (BISAP-O) provides higher sensitivity and diagnostic accuracy to score BISAP and can serve as a parameter to help predict severity in patients with acute pancreatitis. It was not possible to assess the BISAP-O score as a predictor of mortality for patients with acute pancreatitis, due to the low mortality rate in the present study. Further studies are required to validate the score BISAP associated with obesity in predicting severity.
authors.affiliation: Departamento del Aparato Digestivo del Hospital Nacional Edgardo Rebagliati Martins.
authors.forename: Edson
authors.initials: E
authors.lastname: Guzmán Calderon
authors.forename: Pedro
authors.initials: P
authors.lastname: Montes Teves
authors.forename: Eduardo
authors.initials: E
authors.lastname: Monge Salgado
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index