Research Article
BibTex RIS Cite

Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi

Year 2024, , 131 - 137, 28.03.2024
https://doi.org/10.18663/tjcl.1450667

Abstract

Amaç: Akut pankreatitli hastalarda ciddiyetin ve prognozunu tahmin edilmesinde Ranson skoru (RS) ve Balthazar Bilgisayarlı Tomografi Şiddet İndeksini (CTSI) yaygın olarak kullanılmaktadır. Ancak, bu skorlama sistemlerinin biliyer olmayan akut pankreatitin prognouzu tahmin etmedeki tanısal üstünlükleri belirsizliğini korumaktadır. Bu nedenle, bu çalışmada nonbiliyer AP'nin prognozunu tahmin etmede RS ve CTSI'yi karşılaştırmayı amaçladık.
Gereç ve Yöntemler: Bu retrospektif çalışmaya, Ocak 2021 ile Mayıs 2023 arasında İç Hastalıkları kliniğinde takip edilen 67 nonbiliyer AP hastası dahil edildi. RS ve CTSI, hastaların laboratuvar ve radyolojik bulgularına dayanarak hesaplanmıştır. Son noktalar, uzun süreli hastanede yatış (≥8 gün), komplikasyonlar ve mortaliteden oluşmaktadır.
Bulgular: Hastaların ortalama yaşı 50.1±8.3 yıl olup, çoğunluğu erkek (%59.7) idi. Hastaların %11.9'unda komplikasyon gelişti, %26.9'unda uzun süreli hastanede yatış meydana geldi ve %6'sında ölüm gözlendi. Uzun süreli hastanede yatış ve komplikasyon riskini tahmin etmede CTSI, RS'ye göre üstün tanısal performans sergiledi (uzun süreli hastanede kalma için eğri altındaki alan (AUC) = 0.590 vs. 0.856, p <0.05, komplikasyonlar için AUC = 0.615 vs. 0.786, p <0.05), ancak RS mortalite riskini tahmin etmede daha üstün tanısal performans gösterdi (AUC = 0.952 vs. 0.698, p <0.05).
Sonuç: Nonbiliyer AP'nin prognozunda her iki skorlama sisteminin birbirine göre farklı tanısal avantajları vardır ve bunların kombine kullanımı son noktalar için daha güvenilir sonuçlar sağlayabilir.

Project Number

2022/514/242/4

References

  • Cruz-Santamaria DM, Taxonera C, Giner M. Update on pathogenesis and clinical management of acute pancreatitis. World J Gastrointest Pathophysiol. 2012;3:60-70.
  • Szatmary P, Grammatikopoulos T, Cai W, et al. Acute Pancreatitis: Diagnosis and Treatment. Drugs. 2022;82:1251-1276.
  • Wu BU. Prognosis in acute pancreatitis. CMAJ. 2011;183:673-677.
  • Li Y, Zhang J, Zou J. Evaluation of four scoring systems in prognostication of acute pancreatitis for elderly patients. BMC Gastroenterol. 2020;20:165.
  • Wahab S, Khan RA, Ahmad I, Wahab A. Imaging and clinical prognostic indicators of acute pancreatitis: a comparative insight. Acta Gastroenterol Latinoam. 2010;40:283-287.
  • Hu JX, Zhao CF, Wang SL, et al. Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence. World J Gastroenterol. 2023;29:5268-5291.
  • Lee DW, Cho CM. Predicting Severity of Acute Pancreatitis. Medicina (Kaunas). 2022;58:787.
  • Adam G, Koçak E, Çınar C, et al. Evaluation of CT severity index, Ranson and APACHE II and Ranson scores for clinical course and mortality in mechanically ventilated patients depend to severe pancreatitis. Van Medical Journal. 2017;24:238-243.
  • Miko A, Vigh E, Matrai P, et al. Computed Tomography Severity Index vs. Other Indices in the Prediction of Severity and Mortality in Acute Pancreatitis: A Predictive Accuracy Meta-analysis. Front Physiol. 2019;10:1002.
  • Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102-111.
  • Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331-336.
  • Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng KLocalio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol. 1974;61:443-451.
  • Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CLSibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638-1652.
  • Papachristou GI, Machicado JD, Stevens T, et al. Acute pancreatitis patient registry to examine novel therapies in clinical experience (APPRENTICE): an international, multicenter consortium for the study of acute pancreatitis. Ann Gastroenterol. 2017;30:106-113.
  • Valdivielso P, Ramirez-Bueno A, Ewald N. Current knowledge of hypertriglyceridemic pancreatitis. Eur J Intern Med. 2014;25:689-694.
  • Zhu Y, Pan X, Zeng H, et al. A Study on the Etiology, Severity, and Mortality of 3260 Patients With Acute Pancreatitis According to the Revised Atlanta Classification in Jiangxi, China Over an 8-Year Period. Pancreas. 2017;46:504-509.
  • Sekimoto M, Takada T, Kawarada Y, et al. JPN Guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;13:10-24.
  • Feng L, Nian S, Tong Z, et al. Age-related trends in lipid levels: a large-scale cross-sectional study of the general Chinese population. BMJ Open. 2020;10:e034226.
  • Weiss FU, Laemmerhirt F, Lerch MM. Etiology and Risk Factors of Acute and Chronic Pancreatitis. Visc Med. 2019;35:73-81.
  • Fan L, Jiang Y, Kong X, et al. Risk factors analysis for the formation of pancreatic pseudocysts in acute pancreatitis. Chinese Journal of Pancreatology. 2018;6:20-24.
  • Marta K, Lazarescu AM, Farkas N, et al. Aging and Comorbidities in Acute Pancreatitis I: A Meta-Analysis and Systematic Review Based on 194,702 Patients. Front Physiol. 2019;10:328.
  • Lujano-Nicolas LA, Perez-Hernandez JL, Duran-Perez EG, Serralde-Zuniga AE. Corelation among clinical, biochemical and tomographic criteria in order to evaluate the severity in acute pancreatitis. Rev Esp Enferm Dig. 2010;102:376-380.
  • Cho JH, Kim TN, Chung HH, Kim KH. Comparison of scoring systems in predicting the severity of acute pancreatitis. World J Gastroenterol. 2015;21:2387-2394.
  • Imrie CW. Prognostic indicators in acute pancreatitis. Can J Gastroenterol. 2003;17:325-328.
  • Ong Y, Shelat VG. Ranson score to stratify severity in Acute Pancreatitis remains valid - Old is gold. Expert Rev Gastroenterol Hepatol. 2021;15:865-877.
  • Tüzün A, Dalbaşı E, Gül M. The Role Of Apache II, Ranson And Balthazar Scoring Systems On Morbitidy In Patients With Acute Biliary Pancreatitis. Kocaeli Medical Journal. 2020;9:124-130.
  • Leung TK, Lee CM, Lin SY, et al. Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II scoring system in predicting acute pancreatitis outcome. World J Gastroenterol. 2005;11:6049-6052.
  • Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105:435-441; quiz 442.
  • Prajapati R, Manay P, Sugumar K, Rahandale V, Satoskar R. Acute pancreatitis: predictors of mortality, pancreatic necrosis and intervention. Turk J Surg. 2021;37:13-21.
  • Koç Z, Akın S, Boyuk B, Keskin Ö. Comparison of Ranson Criteria and HAPS Score for Prognosis of Patients with Clinical Monitoring due to Non-biliary Acute Pancreatitis. South Clin Ist Euras. 2023;34:8-11.
  • Khanna AK, Meher S, Prakash S, et al. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis. HPB Surg. 2013;2013:367581.
  • Tee YS, Fang HY, Kuo IM, Lin YS, Huang SFYu MC. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine (Baltimore). 2018;97:e9654.

Diagnostic Performance of Scoring Systems in Non-Biliary Acute Pancreatitis Prognosis: A Comparative Analysis of Ranson and Balthazar Scores

Year 2024, , 131 - 137, 28.03.2024
https://doi.org/10.18663/tjcl.1450667

Abstract

Aim: The Ranson score (RS) and the Balthazar Computed Tomography Severity Index (CTSI) are commonly used to predict the severity and prognosis of acute pancreatitis (AP). However, the diagnostic superiority of these scoring systems in predicting the prognosis of non-biliary AP remains unclear. Therefore, this study aimed to compare the RS and CTSI in predicting the prognosis of non-biliary AP.
Material and Methods: This retrospective study included 67 non-biliary AP patients who were followed at the Internal Medicine clinic of Hospital, between January 2021 and May 2023. The RS and CTSI were calculated based on the laboratory and radiological findings of the patients. The endpoints consisted of prolonged hospitalization (≥8 days), complications, and mortality.
Results: The mean age of the patients was 50.1±8.3 years, and the majority were male (59.7%). Complications developed in 11.9% of the patients, prolonged hospitalization occurred in 26.9%, and death occurred in 6%. In predicting the risk of prolonged hospitalization and complications, CTSI exhibited superior diagnostic performance compared to RS (the area under the curve (AUC) = 0.590 vs. 0.856, p <0.05 for prolonged hospitalization, 0.615 vs. 0.786, p <0.05 for complications), while RS showed superior diagnostic performance in predicting the risk of mortality (AUC = 0.952 vs. 0.698, p <0.05).
Conclusion: In the prognosis of non-biliary AP, both scoring systems have different diagnostic advantages compared to each other, and their combined use may provide more reliable results for the endpoints.

Ethical Statement

The study was performed in accordance with the Declaration of Helsinki, and was approved by the University of Health Sciences, Kartal Dr Lütfi Kırdar City Hospital Ethics Committee (Date: 25.01.2023, Decision No: 2022/514/242/4).

Supporting Institution

No

Project Number

2022/514/242/4

References

  • Cruz-Santamaria DM, Taxonera C, Giner M. Update on pathogenesis and clinical management of acute pancreatitis. World J Gastrointest Pathophysiol. 2012;3:60-70.
  • Szatmary P, Grammatikopoulos T, Cai W, et al. Acute Pancreatitis: Diagnosis and Treatment. Drugs. 2022;82:1251-1276.
  • Wu BU. Prognosis in acute pancreatitis. CMAJ. 2011;183:673-677.
  • Li Y, Zhang J, Zou J. Evaluation of four scoring systems in prognostication of acute pancreatitis for elderly patients. BMC Gastroenterol. 2020;20:165.
  • Wahab S, Khan RA, Ahmad I, Wahab A. Imaging and clinical prognostic indicators of acute pancreatitis: a comparative insight. Acta Gastroenterol Latinoam. 2010;40:283-287.
  • Hu JX, Zhao CF, Wang SL, et al. Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence. World J Gastroenterol. 2023;29:5268-5291.
  • Lee DW, Cho CM. Predicting Severity of Acute Pancreatitis. Medicina (Kaunas). 2022;58:787.
  • Adam G, Koçak E, Çınar C, et al. Evaluation of CT severity index, Ranson and APACHE II and Ranson scores for clinical course and mortality in mechanically ventilated patients depend to severe pancreatitis. Van Medical Journal. 2017;24:238-243.
  • Miko A, Vigh E, Matrai P, et al. Computed Tomography Severity Index vs. Other Indices in the Prediction of Severity and Mortality in Acute Pancreatitis: A Predictive Accuracy Meta-analysis. Front Physiol. 2019;10:1002.
  • Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102-111.
  • Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331-336.
  • Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng KLocalio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol. 1974;61:443-451.
  • Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CLSibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638-1652.
  • Papachristou GI, Machicado JD, Stevens T, et al. Acute pancreatitis patient registry to examine novel therapies in clinical experience (APPRENTICE): an international, multicenter consortium for the study of acute pancreatitis. Ann Gastroenterol. 2017;30:106-113.
  • Valdivielso P, Ramirez-Bueno A, Ewald N. Current knowledge of hypertriglyceridemic pancreatitis. Eur J Intern Med. 2014;25:689-694.
  • Zhu Y, Pan X, Zeng H, et al. A Study on the Etiology, Severity, and Mortality of 3260 Patients With Acute Pancreatitis According to the Revised Atlanta Classification in Jiangxi, China Over an 8-Year Period. Pancreas. 2017;46:504-509.
  • Sekimoto M, Takada T, Kawarada Y, et al. JPN Guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;13:10-24.
  • Feng L, Nian S, Tong Z, et al. Age-related trends in lipid levels: a large-scale cross-sectional study of the general Chinese population. BMJ Open. 2020;10:e034226.
  • Weiss FU, Laemmerhirt F, Lerch MM. Etiology and Risk Factors of Acute and Chronic Pancreatitis. Visc Med. 2019;35:73-81.
  • Fan L, Jiang Y, Kong X, et al. Risk factors analysis for the formation of pancreatic pseudocysts in acute pancreatitis. Chinese Journal of Pancreatology. 2018;6:20-24.
  • Marta K, Lazarescu AM, Farkas N, et al. Aging and Comorbidities in Acute Pancreatitis I: A Meta-Analysis and Systematic Review Based on 194,702 Patients. Front Physiol. 2019;10:328.
  • Lujano-Nicolas LA, Perez-Hernandez JL, Duran-Perez EG, Serralde-Zuniga AE. Corelation among clinical, biochemical and tomographic criteria in order to evaluate the severity in acute pancreatitis. Rev Esp Enferm Dig. 2010;102:376-380.
  • Cho JH, Kim TN, Chung HH, Kim KH. Comparison of scoring systems in predicting the severity of acute pancreatitis. World J Gastroenterol. 2015;21:2387-2394.
  • Imrie CW. Prognostic indicators in acute pancreatitis. Can J Gastroenterol. 2003;17:325-328.
  • Ong Y, Shelat VG. Ranson score to stratify severity in Acute Pancreatitis remains valid - Old is gold. Expert Rev Gastroenterol Hepatol. 2021;15:865-877.
  • Tüzün A, Dalbaşı E, Gül M. The Role Of Apache II, Ranson And Balthazar Scoring Systems On Morbitidy In Patients With Acute Biliary Pancreatitis. Kocaeli Medical Journal. 2020;9:124-130.
  • Leung TK, Lee CM, Lin SY, et al. Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II scoring system in predicting acute pancreatitis outcome. World J Gastroenterol. 2005;11:6049-6052.
  • Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105:435-441; quiz 442.
  • Prajapati R, Manay P, Sugumar K, Rahandale V, Satoskar R. Acute pancreatitis: predictors of mortality, pancreatic necrosis and intervention. Turk J Surg. 2021;37:13-21.
  • Koç Z, Akın S, Boyuk B, Keskin Ö. Comparison of Ranson Criteria and HAPS Score for Prognosis of Patients with Clinical Monitoring due to Non-biliary Acute Pancreatitis. South Clin Ist Euras. 2023;34:8-11.
  • Khanna AK, Meher S, Prakash S, et al. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis. HPB Surg. 2013;2013:367581.
  • Tee YS, Fang HY, Kuo IM, Lin YS, Huang SFYu MC. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine (Baltimore). 2018;97:e9654.
There are 32 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Nazire Aladağ 0000-0002-4100-3860

Müjgan Tuna 0000-0001-8603-9333

Seydahmet Akın 0000-0002-2557-3812

Project Number 2022/514/242/4
Publication Date March 28, 2024
Submission Date March 11, 2024
Acceptance Date March 21, 2024
Published in Issue Year 2024

Cite

APA Aladağ, N., Tuna, M., & Akın, S. (2024). Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi. Turkish Journal of Clinics and Laboratory, 15(1), 131-137. https://doi.org/10.18663/tjcl.1450667
AMA Aladağ N, Tuna M, Akın S. Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi. TJCL. March 2024;15(1):131-137. doi:10.18663/tjcl.1450667
Chicago Aladağ, Nazire, Müjgan Tuna, and Seydahmet Akın. “Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson Ve Balthazar Skorlarının Karşılaştırmalı Analizi”. Turkish Journal of Clinics and Laboratory 15, no. 1 (March 2024): 131-37. https://doi.org/10.18663/tjcl.1450667.
EndNote Aladağ N, Tuna M, Akın S (March 1, 2024) Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi. Turkish Journal of Clinics and Laboratory 15 1 131–137.
IEEE N. Aladağ, M. Tuna, and S. Akın, “Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi”, TJCL, vol. 15, no. 1, pp. 131–137, 2024, doi: 10.18663/tjcl.1450667.
ISNAD Aladağ, Nazire et al. “Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson Ve Balthazar Skorlarının Karşılaştırmalı Analizi”. Turkish Journal of Clinics and Laboratory 15/1 (March 2024), 131-137. https://doi.org/10.18663/tjcl.1450667.
JAMA Aladağ N, Tuna M, Akın S. Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi. TJCL. 2024;15:131–137.
MLA Aladağ, Nazire et al. “Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson Ve Balthazar Skorlarının Karşılaştırmalı Analizi”. Turkish Journal of Clinics and Laboratory, vol. 15, no. 1, 2024, pp. 131-7, doi:10.18663/tjcl.1450667.
Vancouver Aladağ N, Tuna M, Akın S. Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi. TJCL. 2024;15(1):131-7.


e-ISSN: 2149-8296

The content of this site is intended for health care professionals. All the published articles are distributed under the terms of

Creative Commons Attribution Licence,

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.