Objective To assess the values of Acute Physiology and Chronic Health Evaluation II ( APACHE II ) and Beside Index of Severe Acute Pancreatitis ( BISAP ) scoring system in predicting the severity, occurrence of organ failure and therapy of patients with acute pancreatitis ( AP ). Methods Nine hundreds and eleven patients with AP were retrospectively studied with these two criteria systems. Differences of scores between the mild group and the severe group, the organ failure group and the non - organ failure group, the surgery group and the non - surgery group were compared. At the same time, differences in severe acute pancreatitis ( SAP ) rates, organ failure rates and surgical rates between the high score group and the low score group were also compared. Results The mean scores of APACHE II and BISAP were significantly different between severe and mild pancreatitis and between the organ failure group and the non - organ failure group ( P <0. 01 ). The mean scores of APACHE II between the surgery group and the non - surgery group were different significantly ( P < 0. 01 ), while the mean scores of BISAP between these two groups were not significantly different ( P > 0. 05 ). For the APACHE II scoring system, differences in the incidence of SAP, organ failure rates and surgery rates were statistically significant between the high score group ( ^10 points ) and the low score group ( < 10 points ) ( P <0. 01 ). For the BISAP scoring system, differences in the incidence of SAP and organ failure rates were statistically significant ( P <0. 01 ), while no significant differences in surgical rates were observed ( P >0. 05 ). Conclusion Both APACHE II and BISAP scoring systems could be all used as important reference for the evaluation of severity and organ failure of AP. BISAP is simple and easy to carry out, patients with high risk of death could be assessed early by this scoring system. So it is expected to be widely used in clinical practice. APACHE II score has a certain value in the choice of treatment, while BISAP score system is instable in determining treatment method.%目的 探讨急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)、严重程度床边指数评分(BISAP)在预测急性胰腺炎(AP)严重程度、器官衰竭发生及治疗方法选择中的应用价值.方法 运用APACHEⅡ、BISAP对911例AP患者进行回顾性评分,比较轻症组与重症组、器官衰竭组与非器官衰竭组、手术组与非手术组的评分差异,比较高分组与低分组之间重症急性胰腺炎(SAP)发生率、器官衰竭发生率以及手术率的差异.结果 重症组与轻症组、器官衰竭组与非器官衰竭组的APACHEⅡ及BISAP差异均有统计学意义(P＜0.01);手术组与非手术组APACHEⅡ差异有统计学意义(P＜0.01),两组BISAP差异无统计学意义(P＞0.05).对于APACHEⅡ,高分组(≥10分)和低分组(＜10分)患者SAP、器官衰竭发生率及手术率间差异均有统计学意义(P＜0.01).对于BISAP,高分组(≥3分)与低分组(＜3分)的SAP及器官衰竭发生率间差异有统计学意义(P＜0.01),两组手术率差异无统计学意义(P＞0.05).结论 APACHEⅡ和BISAP对于判断AP严重程度及器官衰竭均具有重要参考意义.BISAP简便易行,能够早期对AP患者进行死亡风险评估,将有望广泛应用于临床.在治疗方法的选择上,APACHEⅡ具有一定的应用价值,而BISAP的应用价值不稳定.
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