Yu X.-E.,Peoples Hospital Of Baise |
Deng Y.-H.,Peoples Hospital Of Baise |
Huang P.-N.,Peoples Hospital Of Baise |
Cheng J.-Y.,Peoples Hospital Of Baise |
And 5 more authors.
World Chinese Journal of Digestology | Year: 2014
Aim: To compare the value extrapancreatic inflammation on abdominal computed tomography (EPIC) combined with neutropil-lymphocyte rate (NLR) vs bedside index for severity in acute pancreatitis (BISAP) in early prediction of severity of acute pancreatitis (AP).Methods: The clinical, laboratory and CT data obtained on admission (within first 24 h of hospitalization) for 358 patients with AP who were hospitalized from January 2010 to April 2014 were analyzed. The EPIC, NLR, BISAP and modified Marshall scores were calculated in all patients. The combined score was defined as EPIC score plus NLR score. AP was classified as mild AP (MAP), moderately severe AP (MSAP) and severe AP (SAP). The EPIC, NLR, BISAP scores and combined score were compared between groups. The correlation of these scores with severity of AP was analyzed using Spearman test. The AUC, sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index of these scores in early prediction of severity of AP were calculated.Results: There were 303 patients with MAP (mild group) and 55 patients with MSAP or SAP (severe group). The EPIC, NLR, BISAP and combined scores in the severe group were significantly higher than those in the mild group (4.200 ± 1.393 vs 1.373 ± 1.333, 14.358 ± 5.908 vs 7.929 ± 4.514, 2.655 ± 0.985 vs 0.993 ± 0.843, 5.164 ± 1.385 vs 1.819 ± 1.493, P = 0.000 for all). The Spearman correlation coefficients between AP severity and EPIC, NLR, BISAP and combined scores were 0.529, 0.406, 0.546 and 0.554, respectively (P = 0.000 for all). The AUCs of EPIC, NLR, BISAP and combined scores for predicting AP severity were 0.914 (95%CI: 0.867-0.961), 0.825 (95%CI: 0.778-0.872), 0.911 (95%CI: 0.863-0.960) and 0.938 (95%CI: 0.900-0.975), respectively (P = 0.000 for all). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index of BISAP score and combined score for predicting AP severity were 90.909% vs 85.455%, 80.528% vs 86.469%, 82.123% vs 86.313%, 45.872% vs 53.409%, 97.992% vs 97.037%, and 0.714 vs 0.719, respectively.Conclusion: The combined score of EPIC and NLR is easy to obtain and simple. The AUC of the combined score for predicting severity of early AP is larger than that of BISAP score. The specificity and accuracy of the combined score in predicting severity of early AP are higher than those of other indexes. © 2014 Baishideng Publishing Group Inc. All rights reserved.