Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis : Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers-A Prospective Observational Study
Pando, Elizabeth (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Alberti Delgado, Piero (Hospital Universitari Vall d'Hebron)
Mata, Rodrigo (Hospital Universitari Vall d'Hebron)
Gomez, María José (Hospital Universitari Vall d'Hebron)
Vidal, Laura (Hospital Universitari Vall d'Hebron)
Cirera de Tudela, Arturo (Hospital Universitari Vall d'Hebron)
Dopazo, Cristina (Hospital Universitari Vall d'Hebron)
Blanco, Laia (Hospital Universitari Vall d'Hebron)
Gómez Gavara, Concepción (Hospital Universitari Vall d'Hebron)
Caralt, Mireia (Hospital Universitari Vall d'Hebron)
Balsells Valls, Joaquim (Hospital Universitari Vall d'Hebron)
Charco, Ramon (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II), as well as other laboratory tests such as haematocrit and its variations over 24 h and C-reactive protein, in order to determine the most accurate test for predicting mortality and severity outcomes in AP. Clinical data of 410 AP patients, prospectively enrolled for study at our institution, were analyzed. We define AP according to Atlanta classification (AC) 2012. The laboratory test's predictive accuracy was measured using area-under-the-curve receiver-operating characteristics (AUC) analysis and sensitivity and specificity tests. Rise in BUN was the only score related to mortality on the multivariate analysis (p =0. 000, OR: 12. 7; CI 95%: 4. 2−16. 6). On the comparative analysis of AUC, the rise in BUN was an accurate test in predicting mortality (AUC: 0. 842) and persisting multiorgan failure (AUC: 0. 828), similar to the BISAP score (AUC: 0. 836 and 0. 850) and APACHE-II (AUC: 0. 756 and 0. 741). The BISAP score outperformed both APACHE-II and rise in BUN at 24 hours in predicting severe AP (AUC: 0. 873 vs. 0. 761 and 0. 756, respectively). Rise in BUN at 24 hours is a quick and reliable test in predicting mortality and persisting multiorgan failure in AP patients.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Canadian Journal of Gastroenterology & Hepatology, Vol. 2021 (march 2021) , ISSN 2291-2797

DOI: 10.1155/2021/6643595
PMID: 33824864

8 p, 1.2 MB

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