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Overview :
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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