The effect of LUS,APACHE Ⅱ and BISAP score on the prognosis of severe acute pancreatitis
Yang Lihuan
Shang Demin
Wang Haofeng
Wei Lanhai
Abstract：Objective To evaluate the effect of lung ultrasound score(LUS)combined with acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and bedside index for severity in acute pancreatitis(BISAP)on the prognosis of severe acute pancreatitis(SAP).Methods A total of 186 SAP patients admitted to Department of Intensive Care Medicine,Zhangye People's Hospital Affiliated to Hexi University from January 2021 to June 2023 were selected.According to the survival conditions 28 days after admission,the survivors were selected as the control group(n=132)and the dead patients were selected as the death group(n=54).BISAP,APACHE Ⅱ,systemic inflammatory response syndrome(SIRS)scores,laboratory indicators,bedside lung ultrasound and LUS were completed within 24 hours after admission.Ranson score and Glasgow coma score were completed within 48 hours after admission.The differences in various scores and laboratory indicators were compared between two groups,Logistic regression was used to analyze the influencing factors of 28-day death in SAP patients,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of each indicator for 28-day death in SAP patients.Results The LUS,APACHE Ⅱ and BISAP score,serum C-reactive protein and procalcitonin in the death group were higher than those in the control group(P＜0.05).There were no significant differences in SIRS,Ranson and GCS scores,other general data and laboratory indexes between the two groups(P＞0.05).The increase of LUS score,BISAP score and APACHE Ⅱscore was the risk factor for 28-day death in SAP patients(P＜0.05).The area under curve(AUC)of LUS score,BISAP score and APACHE Ⅱ score in predicting 28-day death of SAP patients was 0.842,0.758 and 0.682,respectively.Logistic regression analysis equation was used as a new index for the combined prediction of LUS score,BISAP score and APACHE Ⅱ score for 28-day death of SAP patients,and the AUC of combined prediction was 0.933,which was higher than a single indicator(Z=4.571,P=0.022,Z=5.831,P=0.012,Z=6.523,P=0.005).Conclusions The combination of LUS score,BISAP score and APACHE Ⅱ score has a good value in evaluating the prognosis of SAP.
Keywords：Severe acute pancreatitisPrognosisLung ultrasound scoreAcute physiology and chronic health evaluation ⅡBedside index for severity in acute pancreatitis
Publication Date：2025-02-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 117-121 )