A comparative study between APACHE II and Ranson scoring systems in predicting the severity of acute pancreatitis
Journal Title: International Archives of Integrated Medicine - Year 2019, Vol 6, Issue 4
Abstract
Background: Acute pancreatitis is a common disease with wide clinical variation and its incidence is increasing. Acute pancreatitis may vary in severity, from mild self-limiting pancreatic inflammation to pancreatic necrosis with life-threatening sequelae. The severity of acute pancreatitis is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis. Aim of the study: To compare the efficacy of Ranson scoring with APACHE II scoring system in predicting the severity of acute pancreatitis. Materials and methods: The present study was a prospective study of 33 cases of Acute pancreatitis admitted in Rajiv Gandhi Government General Hospital, Chennai, during the study period of July 2014 to September 2014. 33 cases for the purpose of the study were selected on the basis of the nonprobability (purposive) sampling method. multiple clinical and laboratory variables of both Ranson and APACHE II scoring system and the final score of the patient from both the scoring systems are assessed to know their efficacy in predicting the severity of the disease (higher the score more severe the disease). Results: Overall, 8(24.2%) patients suffered from severe pancreatitis and 25(75.7%) had mild acute pancreatitis of which all 8 had severe attack as per APACHE II score (>8) and only 3 of these were considered severe by Ranson score (>3). The systemic complications were a multiorgan failure in 2(6.06%), respiratory 1(3.03%) and renal 1(3.03%) all seen in patients with the severe score as per APACHE II. Conclusion: The early diagnosis and precise scoring of disease severity are important goals in the initial evaluation and management of pancreatitis. Pancreatitis not only must be differentiated from a myriad of other potential diagnoses, but patients must also be stratified to identify those with severe disease and to guide appropriate therapy.
Authors and Affiliations
Umarani Subramaniam, Ahila Muthuselvi, Dr. Kesavan
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