Assessment of Prognosis of Acute Pancreatitis on Admission: Comparison of HAPS and APACHE II Scoring Systems

Apply

Assessment of Prognosis of Acute Pancreatitis on Admission: Comparison of HAPS and APACHE II Scoring Systems

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9

Abstract

Acute pancreatitis is a common and potentially lethal inflammatory process with a highly variable clinical course. Persistent organ failure develops in 10%–20% of patients, with mortality reaching 30% in this subgroup. Since the morbidity and mortality of acute pancreatitis differ markedly between mild and severe disease (mild < 5% vs severe 20–25%), the ability to identify patients at risk for persistent organ failure early in the disease course is very critical, both for triaging patients to the appropriate level of care and for designing mechanistic studies for targeted intervention. Our study aims toassess the severity of acute pancreatitis using APACHE II and HAPS (Harmless Acute Pancreatitis Score) scoring systems, to compare HAPS and APACHE scoring systems for assessment of prognosis of acute pancreatitis on admission and to assess the feasibility of HAPS scoring system over the complicated APACHE II scoring system.This prospective observational study was conducted on admitted patients clinically suspected to have acute pancreatitis in a tertiary teaching hospital between October 2015 to September 2017. A total of 80 patients were included in the study. Scoring was done on admission or at the time of diagnosis. The scores were compared with the clinical severity which were graded according to Atlanta criteria and also compared with the clinical outcome of the patient. Statistical analysis was done using independent t test. A “p” value of less than 0.05 was considered to be statistically significant.Of the 80 patients studied, 58 (72.5%) patients were positive for HAPS at the time of admission, while 57 (71.25%) patients had an APACHE II score of less than or equal to 8 within 24 hours of admission, signifying uncomplicated mild acute pancreatitis, while eventually 55 (68.8%) patients were found to have a mild course of the disease. As all the indices of statistical power were found to be the more or less the same for both HAPS and APACHE II scores, HAPS is as efficacious as APACHE II scoring system for identifying patients with mild course of the disease at the time of admission, while having the added advantages of being significantly less time-consuming, cumbersome and less invasive and at the same time accurately triaging patients as per disease severity. This indicates that HAPS is capable of identifying the patients who could be reliably triaged to receive less aggressive treatment, making it an ideal predictor for Indian patients at the community level.

Authors and Affiliations

Nigil Abdul Jalal

Keywords

EP ID EP395574
DOI 10.9790/0853-1709141118.
Views 81
Downloads 0