Diagnostic value of serum lipase combined with Ranson or BISAP scoring system in assessment of severity of acute pancreatitis

Objective To investigate the diagnostic value of serum lipase combined with the Ranson or BISAP scoring system in the assessment of severity of acute pancreatitis. Methods A total of 314 patients with acute pancreatitis who were admitted to The Second People' s Hospital of Huidong County from February 2012 to February 2015 were selected and divided into mild acute acute pancreatitis( MAP) group( 202 patients) and severe acute pancreatitis( SAP) group( 112 patients). Serum lipase determination,Ranson scoring,BISAP scoring,serum lipase determination combined with Ranson scoring,and serum lipase determination combined with BISAP scoring were performed for all the patients. The t- test was applied for comparison of continuous data between groups,the chi- square test was applied for comparison of categorical data between groups,and the Z test was applied for the comparison of area under the receiver operating characteristic curve( AUC) and Youden index between different methods. Results The patients with SAP had significantly higher serum lipase level,Ranson score,and BISAP score than those with MAP( t = 14. 89,11. 89,and 5. 12,P = 0. 003,0. 007,and 0. 037). As for the AUCs for the prediction of organ failure,pancreatic necrosis,and death,serum lipase determination combined with the BISAP scoring system had significantly higher AUCs than the BISAP scoring system( Z = 7. 54,7. 11,and 7. 57,P = 0. 033,0. 031,and 0. 030),serum lipase determination combined with the Ranson scoring system had significantly higher AUCs than the Ranson scoring system( Z = 5. 23,5. 78,and 6. 18,P =0. 037,0. 034,and 0. 032),and serum lipase determination combined with the BISAP scoring system had significantly higher AUCs than serum lipase determination combined with the Ranson scoring system( Z = 13. 55,8. 33,and 7. 66,P = 0. 005,0. 029,and 0. 031). As for Youden index for the prediction of organ failure,pancreatic necrosis,and death,serum lipase determination combined with the Ranson scoring system had a significantly higher Youden index than the Ranson scoring system( Z = 5. 17,6. 89,and 7. 35,P = 0. 038,0. 032,and 0. 027),serum lipase determination combined with the BISAP scoring system had a significantly higher Youden index than the BISAP scoring system( Z = 7. 54,7. 22,and 9. 57,P = 0. 030,0. 031,and 0. 025),and serum lipase determination combined with the BISAP scoring system had a significantly higher Youden index than serum lipase determination combined with the Ranson scoring system( Z =10. 11,10. 23,and 13. 24,P = 0. 020,0. 019,and 0. 010). Conclusion Compared with the Ranson scoring system or BISAP scoring system alone,serum lipase determination combined with the Ranson or BISAP scoring system is more accurate in the assessment of severity of acute pancreatitis,and serum lipase determination combined with the BISAP scoring system has a higher sensitivity and a greater diagnostic value in clinical practice.