Volume : 7, Issue : 11, November - 2018

Comparison of different scoring systems in predicting the severity of acute pancreatitis

Dr. Milind Parekh, Dr. Dax H Prajapati

Abstract :

<p>&nbsp;</p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;line-height:normal;background:white"><span style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;">AIM: to compare the different scoring systems in predicting the severity of acute pancreatitis (AP).<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;line-height:normal;background:white"><span style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;">METHODS: We Prospectively analysed the database from consecutive patients with AP in VS Hospital between December 2017 and July 2018. Ranson, Acute Physiology and Chronic Health Evaluation (APACHE)-II, and bedside index for severity in acute pancreatitis (BISAP) scores of all patients were calculated. Predictive accuracy of scoreswere measured by different statistical analysis.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:8.3pt;&#10;margin-left:0in;line-height:normal;background:white"><span style="font-size:&#10;14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">RESULTS: Of 60 patients, 7 (12%) were classified as severe AP, and 1 (1.9%) died. Statistically significant cutoff values for prediction of severe AP were Ranson &ge; 3, BISAP &ge; 2, APACHE-II &ge; 8, Negative predictive value is almost same in all where sensitivity are 86 %, 61.9 % and 81 % in RANSON, BISAP<span style="mso-spacerun:yes">&nbsp; </span>and APACHE scores. No statistically significant pairwise differences were observed between APACHE-II and the other scoring systems²²._<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:8.3pt;margin-right:0in;margin-bottom:8.3pt;&#10;margin-left:0in;line-height:normal;background:white"><span style="font-size:&#10;14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">CONCLUSION: Various scoring systems showed similar predictive accuracy for severity of AP. Unique models are needed in order to achieve further improvement of prognostic accuracy.<o:p></o:p></span></p>