title: BISAP, RANSON, lactate and others biomarkers in prediction of severe acute pancreatitis in a European cohort.
abstract: OBJECTIVE
  The study aims to assess and compare the predicting ability of some scores and biomarkers in acute pancreatitis.
  
  
  METHODS
  We prospectively collected data from 269 patients diagnosed of acute pancreatitis, admitted to Virgen de las Nieves University Hospital between June 2010 and June 2012. Blood urea nitrogen (BUN), C-reactive protein, and creatinine were measured on admission and after 48 h, lactate and bedside index for severity acute pancreatitis (BISAP) only on admission and RANSON within the first 48 h. Definitions from 2012 Atlanta Classification were used. Area under the curve (AUC) was calculated for each scoring system for predicting severe acute pancreatitis (SAP), mortality, and intensive care unit (ICU) admission, obtaining optimal cut-off values from the receiver operating characteristic curves.
  
  
  RESULTS
  Eight (3%) patients died, 17 (6.3%) were classified as SAP, and 10 (3.7%) were admitted in ICU. BISAP was the best predictor on admission for SAP, mortality, and ICU admission with an AUC of 0.9 (95% CI 0.83-0.97); 0.97 (95% CI 0.95-0.99); and 0.89 (95% CI 0.79-0.99), respectively. After 48 h, BUN 48 h was the best predictor of SAP (AUC = 0.96 CI: 0.92-0.99); BUN 48 h and BISAP were the best predictors for mortality (AUC = 0.97 CI: 0.95-0.99) and creatinine 48 h for ICU admission (AUC = 0.96 CI: 0.92-0.99). Lactate showed an AUC of 0.79 (CI: 0.71-0.88), 0.87 (CI: 0.78-0.96), and 0.77 (CI: 0.67-0.87) for SAP, mortality, and ICU admission, respectively. All parameters were predictors for SAP, mortality, and ICU admission, but C-reactive protein on admission was only a significant predictor of SAP.
  
  
  CONCLUSIONS
  Bedside index for severity acute pancreatitis is a good predictive system for SAP, mortality, and ICU admission, being useful for triaging patients for ICU management. Lactate could be useful for developing new scores.
authors.affiliation: Department of Gastroenterology and Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
authors.forename: Francisco
authors.identifier: http://orcid.org/0000-0002-3255-3289
authors.initials: F
authors.lastname: Valverde-López
authors.affiliation: Department of Gastroenterology and Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Matas-Cobos
authors.affiliation: Department of Gastroenterology and Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Alegría-Motte
authors.affiliation: Department of Gastroenterology and Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
authors.forename: Rita
authors.initials: R
authors.lastname: Jiménez-Rosales
authors.affiliation: Department of Gastroenterology and Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Úbeda-Muñoz
authors.affiliation: Department of Gastroenterology and Hepatology, "Virgen de las Nieves" University Hospital, Granada, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Redondo-Cerezo
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D002097:C-Reactive Protein; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000145:classification / Q000175:diagnosis* / Q000401:mortality; D010343:Patient Admission / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D007773:Lactates; D002097:C-Reactive Protein; D003404:Creatinine
keywords: clinical acute pancreatitis; epidemiology; pancreas