title: [BISAP-O y APACHE-O: utility in predicting severity in acute pancreatitis in modified Atlanta classification].
abstract: OBJECTIVE
  To assess the BISAP and APACHE II scores in predicting severity according to the 2012 Atlanta classification and whether the obesity factor added to these scores improves prediction.
  
  
  METHODS
  A prospective study between January 2013 and April 2014 including all patients with acute pancreatitis was performed according to the new Atlanta 2012 classification. ROC curves were fabricated for BISAP, BISAP-O, APACHE-II scores and Apache O and appropriate cutoffs were selected to the sensitivity, specificity, PPV, NPV, RPP and RPN.
  
  
  RESULTS
  We studied 334 patients. 65.27% were overweighted or obese. The biliar etiology was 86.53%. Only 8.38% had severe pancreatitis and 1.5% died. Areas under the ROC curve and cut points selected were: BISAP: 0.8725, 2; BISAP-O: 0.8246, 3; APACHE-II: 0.8547, 5; APACHE-O: 0.8531, 6. Using these cutoffs the sensitivity, specificity, PPV, NPV, RPP and RPN were BISAP: 60.71%, 91.83%, 40.48%, 96.23 %, 7.43, 0.43; BISAP-O: 60.71%, 86.93%, 29.82%, 96.03%, 4.76, 0.45; APACHE-II: 85.71%, 76.14%, 24.74%, 98.31%, 3.6, 0.19; APACHE-O: 82.14%, 79.41%, 26.74%, 97.98%, 4, 0.22.
  
  
  CONCLUSIONS
  BISAP, BISAP-O, APACHE-II and APACHE-O systems can be used to identify patients at low risk of severity because of its high NPV, however their use should be cautious considering that the RPP and RPN do not reach optimal levels indicating that their value in predicting severity is limited. On the other hand adding the obesity factor did not improve their predictive ability.
authors: Universidad Peruana Cayetano Heredia. Lima, Perú.
authors: Agnetha
authors: A
authors: Pérez Campos
authors: Universidad Peruana Cayetano Heredia. Lima, Perú; Servicio de Gastroenterología, Hospital Nacional Cayetano Heredia. Lima, Perú.
authors: Eduar
authors: E
authors: Bravo Paredes
authors: Universidad Peruana Cayetano Heredia. Lima, Perú; Servicio de Gastroenterología, Hospital Nacional Cayetano Heredia. Lima, Perú.
authors: Ricardo
authors: R
authors: Prochazka Zarate
authors: Universidad Peruana Cayetano Heredia. Lima, Perú.
authors: Alejandro
authors: A
authors: Bussalleu
authors: José
authors: J
authors: Pinto Valdivia
authors: Servicio de Gastroenterología, Hospital Nacional Cayetano Heredia. Lima, Perú.
authors: Vannessa
authors: V
authors: Valenzuela Granados
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index