Evaluación de la escala de BISAP en el pronóstico de la pancreatitis aguda

Abstract

Background: It is important to stratify patients with acute pancreatitis according to their risk. Many staging systems for acute pancreatitis have been proposed, each with advantages and disadvantages. Aim: To evaluate the sensitivity, specificity, positive and negative predictive value of the BISAP system. Material and Methods: Retrospective crosses sectional study, which included all patients that presented with acute pancreatitis to a private hospital in Mexico City from 2003 to 2009. The variables needed to calculate BISAP and complications were obtained from the medical records. Results: The records of 345 patients with a mean aged of 52 years (57% males) were analyzed. Twelve percent had complications and 2.3% died. Patients with a BISAP score over three had a significantly higher mortality. The sensitivity, specificity and positive predictive value of a BISAP score over three for mortality were 12.5, 92.9 and 4%, respectively. Conclusions: Because of its high negative predictive value and specificity the BISAP system can be used to stratify patients who are at low risk for complications related to pancreatitis. If the patient has a score of 3 or higher it is necesary to use other scoring systems which are more sensitive and have a higher positive predictive value.