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Predictive value of the Ranson and BISAP scoring systems for the severity and prognosis of acute pancreatitis: A systematic review and meta-analysis.
Zhu, Jianpeng; Wu, Linfei; Wang, Yue; Fang, Mengdie; Liu, Qiang; Zhang, Xiaofeng.
Afiliación
  • Zhu J; The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
  • Wu L; The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
  • Wang Y; Zhejiang University of Medicine, Hangzhou, Zhejiang, China.
  • Fang M; The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
  • Liu Q; Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
  • Zhang X; Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
PLoS One ; 19(4): e0302046, 2024.
Article en En | MEDLINE | ID: mdl-38687745
ABSTRACT

BACKGROUND:

To systematically assess and compare the predictive value of the Ranson and Bedside Index of Severity in Acute Pancreatitis (BISAP) scoring systems for the severity and prognosis of acute pancreatitis (AP).

METHODS:

PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until February 15, 2023. Outcomes in this analysis included severity and prognosis [mortality, organ failure, pancreatic necrosis, and intensive care unit (ICU) admission]. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the quality of diagnostic accuracy studies. The threshold effect was evaluated for each outcome. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve (AUC) as well as 95% confidence intervals (CI) were calculated. The DeLong test was used for AUC comparisons. For the outcome evaluated by over 9 studies, publication bias was assessed using the Deeks' funnel plot asymmetry test.

RESULTS:

Totally 17 studies of 5476 AP patients were included. For severity, the pooled sensitivity of the Ranson and BISAP was 0.95 (95%CI 0.87, 0.98) and 0.67 (95%CI 0.27, 0.92); the pooled specificity of the Ranson and BISAP was 0.74 (0.52, 0.88) and 0.95 (95%CI 0.85, 0.98); the pooled AUC of the Ranson and BISAP was 0.95 (95%CI 0.93, 0.97) and 0.94 (95%CI 0.92, 0.96) (P = 0.480). For mortality, the pooled sensitivity of the Ranson and BISAP was 0.89 (95%CI 0.73, 0.96) and 0.77 (95%CI 0.58, 0.89); the pooled specificity of the Ranson and BISAP was 0.79 (95%CI 0.68, 0.87) and 0.90 (95%CI 0.86, 0.93); the pooled AUC of the Ranson and BISAP was 0.91 (95%CI 0.88, 0.93) and 0.92 (95%CI 0.90, 0.94) (P = 0.480). For organ failure, the pooled sensitivity of the Ranson and BISAP was 0.84 (95%CI 0.76, 0.90) and 0.78 (95%CI 0.60, 0.90); the pooled specificity of the Ranson and BISAP was 0.84 (95%CI 0.63, 0.94) and 0.90 (95%CI 0.72, 0.97); the pooled AUC of the Ranson and BISAP was 0.86 (95%CI 0.82, 0.88) and 0.90 (95%CI 0.87, 0.93) (P = 0.110). For pancreatic necrosis, the pooled sensitivity of the Ranson and BISAP was 0.63 (95%CI 0.35, 0.84) and 0.63 (95%CI 0.23, 0.90); the pooled specificity of the Ranson and BISAP was 0.90 (95%CI 0.77, 0.96) and 0.93 (95%CI 0.89, 0.96); the pooled AUC of the Ranson and BISAP was 0.87 (95%CI 0.84, 0.90) and 0.93 (95%CI 0.91, 0.95) (P = 0.001). For ICU admission, the pooled sensitivity of the Ranson and BISAP was 0.86 (95%CI 0.77, 0.92) and 0.63 (95%CI 0.52, 0.73); the pooled specificity of the Ranson and BISAP was 0.58 (95%CI 0.55, 0.61) and 0.84 (95%CI 0.81, 0.86); the pooled AUC of the Ranson and BISAP was 0.92 (95%CI 0.81, 1.00) and 0.86 (95%CI 0.67, 1.00) (P = 0.592).

CONCLUSION:

The Ranson score was an applicable tool for predicting severity and prognosis of AP patients with reliable diagnostic accuracy in resource and time-limited settings. Future large-scale studies are needed to verify the findings.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreatitis / Índice de Severidad de la Enfermedad Límite: Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreatitis / Índice de Severidad de la Enfermedad Límite: Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China
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