Meta-analysis of the diagnostic value of blood urea nitrogen for the severity of acute pancreatitis
Objective To systematically evaluate the diagnostic potential of blood urea nitrogen(BUN)as a biomarker for early severe acute pancreatitis(SAP).Methods The China Knowledge Infrastructure Journal Full-text database,VIP database,Wanfang database,PubMed,Embase,Web of Science and the Cochrane Library were searched for studies on BUN and acute pancreatitis(AP)from inception to March 2023.Two researchers independently screened and reviewed the literatures,conducted quality assessment and extracted data,and performed subgroup analysis on sample size,detection sampling time and critical value.Meta-analysis of all data was performed by Stata17.0 and Meta-Disc1.4 software.Results A total of 7 literatures and 1 642 patients with AP were included,including 150 patients with SAP and 225 patients with moderate severe acute pancreatitis(MSAP).Meta-analysis results showed,the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio(DOR)of BUN in the diagnosis of SAP were 0.67(95%CI:0.57-0.76),0.83(95%CI:0.77-0.87),3.83(95%CI:3.17-4.62),0.40(95%CI:0.31-0.52)and 9.58(95%CI:6.99-13.13),respectively.The summary receiver operating characteristic curve(SROC)showed that the area under the curve(AUC)of BUN was 0.82(95%CI:0.79-0.86),indicating that BUN had a certain accuracy in diagnosing the severity of AP.Subgroup analysis and heterogeneity survey suggested that sample size and sampling time were potential sources of heterogeneity.The publication bias result assessed by Deek's funnel plot showed that there was little possibility of publication bias(P=0.64).Conclusion The BUN has high accuracy in predicting the severity of AP,and has convenient detection and low price.It can be used as a useful supplement to AP classification and provide new ideas in the clinical treatment decision-making process.
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