Comparison of the BISAP scores for predicting the severity of acute pancreatitis in Chinese patients according to the latest Atlanta classification.BACKGROUND
 The bedside index of severity in acute pancreatitis (BISAP) is a new, convenient, prognostic multifactor scoring system.  As there were no studies designed to validate this system according to the latest Atlanta classification in China and more data are needed before clinical application, we compared BISAP, the Acute Physiology and Chronic Health Evaluation (APACHE) II and Ranson scoring systems in predicting the severity, pancreatic necrosis and mortality of acute pancreatitis (AP) using the latest 2012 Atlanta classification in a tertiary care center in China.


 The capacity of the BISAP, APACHE II and Ranson's score system to predict severity, pancreatic necrosis and mortality was evaluated using linear-by-linear association.  The predictive accuracy of the BISAP, APACHE II and Ranson's score was measured as the area under the receiver operating characteristic curve (AUC).


 There were statistically significant trends for increasing severity (P < 0.001), PNec (P < 0.001) and mortality (P < 0.001) with increasing BISAP.  The AUC for severity predicted by BISAP was 0.793 (95% confidence interval [CI] 0.700-0.886), APACHE II 0.836 (95% CI 0.744-0.928) and by Ranson score was 0.903 (95% CI 0.814-0.992).  The AUC for PNec predicted by BISAP was 0.834 (95% CI 0.739-0.929), APACHE II 0.801 (95% CI 0.691-0.910) and by Ranson score was 0.840 (95% CI 0.741-0.939).  The AUC for mortality predicted by BISAP was 0.791 (95% CI 0.593-0.989), APACHE II 0.812 (95% CI 0.717-0.906) and by Ranson score was 0.904 (95% CI 0.829-0.979).


 BISAP score may be a valuable source for risk stratification and prognostic prediction in Chinese patients with AP.  A prospective and multicenter validation study is required to confirm our results and further our recognition of BISAP scores in AP.
BISAP
As there were no studies designed to validate this system according to the latest Atlanta classification in China and more data are needed before clinical application, we compared BISAP, the Acute Physiology and Chronic Health Evaluation (APACHE) II and Ranson scoring systems in predicting the severity, pancreatic necrosis and mortality of acute pancreatitis (AP) using the latest 2012 Atlanta classification in a tertiary care center in China.



the Acute Physiology and Chronic Health Evaluation (APACHE) II
As there were no studies designed to validate this system according to the latest Atlanta classification in China and more data are needed before clinical application, we compared BISAP, the Acute Physiology and Chronic Health Evaluation (APACHE) II and Ranson scoring systems in predicting the severity, pancreatic necrosis and mortality of acute pancreatitis (AP) using the latest 2012 Atlanta classification in a tertiary care center in China.



Ranson scoring systems