“Comparative Study Of Ranson’s Versus Apache Ii Scoring Systems In Predicting The Clinical Outcome In Patients With Acute Pancreatitis”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 7
Abstract
OBJECTIVE: To assess the prognostic accuracy of Ranson and APACHE II and III scoring systems in predicting the severity of acute pancreatitis. METHODS: A time bound prospective study was conducted on patients admitted with acute pancreatitis during the study period from December 2015 to December 2017. After considering both inclusion and exclusion criteria, total number of patients included in the study were 40. All the 40 patients were subjected to both Ranson’s and APACHE II scoring systems. Scoring was done on admission/time of diagnosis and at 48 hours. The scores were compared with the clinical outcome. RESULTS: One hundred nineteen cases of pancreatitis were classified as mild, and 34 were classified as severe. The mortality rate was 3.2%. All three scores correlated with length of stay and disease severity. AUC for Ranson was found to be significantly larger than AUC for APACHE II and APACHE III score (0.817, cut-off > or =3; 0.618, cut-off, > or =10; and 0,676, cut-off > or =42 respectively). The Ranson score achieved the highest sensitivity and the lowest false-negative rate, but the positive and negative predictive values and LRPT were of similar extent for all three scores. CONCLUSION: The APACHE III offers little, if any, advantage over the APACHE II score. Ranson criteria proved to be as powerful a prognostic model as the more complicated APACHE II and III scoring systems, but with the disadvantage of a 24-hour delay.
Authors and Affiliations
Dr. P. Vanitha, M. S. D. G. O, Dr. Vivek Post Graduate
Keywords
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- EP ID EP377390
- DOI 10.9790/0853-1707080109.
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