Values of different biochemical indices and clinical scoring systems for the assessment of acute biliary pancreatitis in a Chinese population.

OBJECTIVE: To investigate values of biochemical indices and clinical scoring systems for the assessment of acute biliary pancreatitis (ABP).

METHODS: Clinical characteristics, laboratory values including procalcitonin (PCT), and radiologic examinations of all ABP patients with mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), or severe acute pancreatitis (SAP) were recorded within 48 hours after the onset of acute pancreatitis. Scores of the Accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Bedside Index of Severity in Acute Pancreatitis (BISAP), Computed Tomography Severity Index (CTSI), Ranson, Japanese Severity Score (JSS), Pancreatitis Outcome Prediction (POP) Score and Systemic Inflammatory Response Syndrome (SIRS) score were then calculated. The area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve was used to analyze the predictive values of biochemical indexes and scoring systems for ABP severity and organ failure.

RESULTS: The percentage of patients over 60 in the SAP group was higher than in the MAP and MSAP groups. PCT had the highest value for predicting SAP (AUC = 0.84, P < 0.001) and organ failure (AUC = 0.87, P < 0.001). The AUCs of APACHE II, BISAP, JSS and SIRS for predicting severity were 0.87, 0.83, 0.82, and 0.81, respectively (all P < 0.001). As for organ failure, the AUCs were 0.87, 0.85, 0.84, and 0.82, respectively (all P < 0.001).

CONCLUSIONS: PCT has a high value for predicting ABP severity and organ failure. Among the clinical scoring systems, BISAP and SIRS are more suitable for early assessment of AP; while APACHE II and JSS are more suitable for monitoring disease progression after thorough examination.