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Acute Pancreatitis Prognostic Model

Purpose: To evaluate a patient with acute pancreatitis using the BALI score of Spitzer et al.

Description

Spitzer et al developed a simple prognostic model for evaluating a patient with acute pancreatitis. This can help identify a patient on admission who may require more aggressive management. The authors are from the University of California San Francisco, University of California East Bay, University of Nevada, University of South Florida and Cornell Medical Center.


Time for evaluation: on admission or at any time during the first 48 hours of hospitalization

 

Parameters for the BALI score:

(1) BUN

(2) age

(3) serum LDH

(4) serum interleukin-6 (IL-6)

 

Parameters

Finding

Points

BUN

< 25 mg/dL

0

 

>= 25 mg/dL

1

age

< 65 years of age

0

 

>= 65 years of age

1

serum LDH

< 300 IU/L

0

 

>= 300 IU/L

1

serum IL-6

< 300 pg/mL

0

 

>= 300 pg/mL

1

 

BALI score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximums score: 4

• A score >= 3 indicated severe disease with an increased risk for mortality.

 

Score

Risk of Mortality

0

0

1 or 2

5%

3

27%

4

54%

 

Performance:

• With a score >= 3 the sensitivity was 69-82% and specificity 83-85%.

• The area under the ROC curve was 0.82, which is slightly better than the Ranson, Glasgow and APACHE II score.

 

Limitations:

• The methods and reference ranges for serum LDH and IL-6 were not given.


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Specialty

Objective

ICD-10