scholarly journals PANC 3 score as a simple cost-effective scoring system in predicting severity of acute pancreatitis

2017 ◽  
Vol 4 (12) ◽  
pp. 4066
Author(s):  
Charan Panda ◽  
Niranjan Kumar Nayak ◽  
Manas Ranjan Behera ◽  
Sanjit Kumar Nayak
Keyword(s):  
Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Inflammatory Process ◽  
Cost Effective ◽  
Systemic Complications ◽  
Complex Calculation ◽  
Stratification System ◽  
Time Of Admission ◽  
Local And Systemic Complications

Background: Acute pancreatitis presents as acute abdomen, is an inflammatory process of the pancreas associated with local and systemic complications requiring, in such cases, an intensive care. At present, there are lots of scores (such as Ranson’s, APACHE II, bedside index for severity in acute pancreatitis) that help us in predicting severity at the time of admission, but these are time consuming or require complex calculation and are costly. Our aim here is to analyse the simplified stratification system of the PANC 3 score, and its assessment in Predicting Severity of Acute Pancreatitis as decided by modified Marshals score.Methods: It is a prospective analytical observational study in which 74 patients were evaluated with PANC 3 scoring, who were diagnosed with acute pancreatitis and admitted to Dept. Of General Surgery, MKCG.Results: The results showed that PANC3 score had a 95.91% specificity, 68% sensitivity, 89.47% positive predictive value, and 85.45% negative predictive value, 86.48% diagnostic accuracy.Conclusions: PANC3 scoring system is one of the better systems because the three criteria used (haematocrit, body mass index, and pleural effusion) are simple, easy to assess, readily available, and economic Hence, the PANC3 score is a cost-effective, promising score that helps in predicting the severity of acute pancreatitis and triaging the patient, leading to prompt management.

scholarly journals Comparison of BISAP and Ranson’s score for predicting severe acute pancreatitis and establish the validity of BISAP score

2020 ◽  
Vol 7 (5) ◽  
pp. 1473
Author(s):  
Amulya Aggarwal ◽  
Alok V. Mathur ◽  
Ram K. Verma ◽  
Megha Gupta ◽  
Dheeraj Raj
Keyword(s):  
Acute Pancreatitis ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Treatment Protocol ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Clinical Scoring

Background: Pancreatitis can lead to serious complications with severe morbidity and mortality. So an early, quick and accurate scoring system is necessary to stratify the patients according to their severity so as to enable early initiation of required management and care. Scoring system commonly used have some drawbacks. This study aimed to compare bedside index for severity in acute pancreatitis (BISAP) and Ranson’s score to predict severe acute pancreatitis and establish the validity of a simple and accurate clinical scoring system for stratifying patients.Methods: This is a prospective comparative study on 100 patients diagnosed with acute pancreatitis admitted in department of general surgery. Parameters included in the BISAP and Ranson’s criteria were studied at the time of admission and after 48 hours. Result of these two were compared with that of revised Atlanta classification.Results: As per the BISAP score, the sensitivity and specificity were 95.8 % (95% CI, 76.8-99.8), 94.7 % (95% CI, 86.3-98.3) whereas positive likelihood ratio, negative likelihood ratio 18.21 (95% CI, 6.9-47.44), 0.04 (95% CI, 0.01-0.30) and accuracy was 95 % (95% CI, 88.72%-98.36%). On using Ranson’s score, the sensitivity and specificity were 91.6 (95% CI, 71.5-98.5) and 89.4 (95% CI, 79.8-95) with a positive predictive value 8.71 (95% CI, 4.47-18.96) and negative predictive value of 0.09 (95% CI, 0.02-0.35) and accuracy of 90% (95% CI, 82.38%-95.10%)..Conclusions: BISAP score outperformed Ranson’s score in terms of Sensitivity and specificity of prediction of severe pancreatitis. The authors recommend inclusion of BISAP Scoring system in standard treatment protocol of management of acute pancreatitis.

scholarly journals Magnetic Resonance Imaging for the Normal Mesostenium and Involvement of the Mesostenium in Acute Pancreatitis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Xiao Xiao Chi ◽  
Xiao Ming Zhang ◽  
Tian Wu Chen ◽  
Wei Tang ◽  
Bo Xiao ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Magnetic Resonance ◽  
Severity Index ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Systemic Complications ◽  
The Relationship ◽  
Local And Systemic Complications

The main point of this paper is to study MRI findings of the normal mesostenium and the involvement of the mesostenium in acute pancreatitis and to discuss the relationship between the involvement of the mesostenium and the severity of acute pancreatitis. In clinical practice, the mesenterical involvement in acute pancreatitis was often observed on MRI in daily works, which was little recorded in the reported studies. We conducted the current study to assess the mesenterical involvement in acute pancreatitis with MRI. We found that the mesenterical involvement of acute pancreatitis patients is common on MRI. The mesenterical involvement has a positive correlation with the MR severity index and the Acute Physiology and Chronic Healthy Evaluation II scoring system. It has been shown that MR can be used to visualize mesenterical involvement, which is a supplementary indicator in evaluating the severity of acute pancreatitis and local and systemic complications.

Potential role of interleukin-18 (IL-18) in the development of local and systemic complications in acute pancreatitis

2000 ◽  
Vol 118 (4) ◽  
pp. A164
Author(s):  
Bettina Rau ◽  
Katja Baumgart ◽  
Adam S. Paszkowski ◽  
Jens M. Mayer ◽  
Hans G. Beger
Keyword(s):  
Acute Pancreatitis ◽  
Potential Role ◽  
Interleukin 18 ◽  
Systemic Complications ◽  
Local And Systemic Complications

scholarly journals Evaluation of the prognostic value of the neutrophil to lymphocyte ratio, lactate dehydrogenase enzyme, and proteinuria in patients with acute pancreatitis admitted at Assiut University Hospitals and its correlation with Ranson’s criteria scoring system

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Lobna Abdel-wahid Ahmed ◽  
Abd-Alla Ismail Ali Kelani ◽  
Fady Refaat Edwar Nasr-Allah
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Lactate Dehydrogenase ◽  
Scoring System ◽  
Prognostic Value ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Dehydrogenase Enzyme ◽  
The Mean ◽  
Time Of Admission

Abstract Background Acute pancreatitis is a relatively common acute medical presentation that may progress beyond the pancreas to cause multi-organ failure or death. It is associated with high morbidity and mortality with mortality rates changing little in the past few decades despite advances in intensive care and surgical management. Early evaluation of acute pancreatitis severity is essential to allow the clinician to predict the patient’s clinical course, estimate the prognosis, determine the need for intensive care unit admission, and prevent complications. So, the purpose of our study is to evaluate the prognostic value of the neutrophil to lymphocyte ratio, lactate dehydrogenase enzyme, and proteinuria in patients with acute pancreatitis and its correlation with Ranson’s criteria scoring system as new, rapid, and easy parameters to predict severity of acute pancreatitis. Results The mean age of patients in years was 47.97, and the median was 52 with a range of ages between 18 and 87; 38% of the patients included were males, and 61% were females. The mean Ranson’s score was 2.77 ± 1.4, and the median was 3 with a range of 0–6; 44.5% of patients included have low severity, 42.4% have mild severity, and 13.1% of patients have high severity. Neutrophil to lymphocyte ratio both at the time of admission and after 48 h of admission was significantly increasing with an increase in disease severity with a P value of < 0.001 that was statistically significant. Lactate dehydrogenase enzyme at the time of admission was also significantly increasing with diseased severity with a P value of 0.001 that was statistically significant and the same for lactate dehydrogenase enzyme level after 48 h of admission with a P value of 0.002 that was also statistically significant. Proteinuria is positive only in 15.2% of patients and with the same result after 48 h of admission. Conclusion The neutrophil to lymphocyte ratio gives a rapid impression of the extent of the inflammatory process, and it can effectively predict severity at the time of admission and even after 48 h of admission and can also differentiate between patients with mild and severe acute pancreatitis in both calcular and non-calcular cause-dependent acute pancreatitis patients. Lactate dehydrogenase can be used to predict severity in calcular cause-dependent acute pancreatitis patients only at the time of admission and after 48 h of admission. Proteinuria in urine analysis on admission and after 48 h does not seem to be a reliable predictor for disease severity in acute pancreatitis.

scholarly journals Comparison of Ranson’s and Glasgow criteria with revised Atlanta in prediction of mortality in acute pancreatitis patients

2019 ◽  
Vol 6 (5) ◽  
pp. 1629
Author(s):  
Deepa Nambi ◽  
Bhanumati Giridharan
Keyword(s):  
Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Surgical Intervention ◽  
Predictive Accuracy ◽  
Statistical Significance ◽  
P Value ◽  
Operating Characteristics ◽  
Icu Admission ◽  
Prediction Of Mortality

Background: To compare the performance of Ranson’s Score (RS) and Glasgow Score (GS) with Revised Atlanta Classification (RAC) in prediction of mortality, and to check their suitability to replace RAC for surgical intervention of gallstone induced acute pancreatitis (GAP).Methods: A hospital based prospective study was conducted between April 2014 and May 2017 with patients presenting with GAP. RS and GS was evaluated using data in first 24 hours and at 48 hours post admission. Patients were classified into mild, moderate and severe based on RAC at the time of hospital stay. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each scoring system. Receiver Operating Characteristics (ROC) curves for mortality, ICU admission, Organ Failure (OF) and Gallstone Recurrence (GR) were plotted and predictive accuracy of each scoring system was measured by the Area under Curve (AUC). AUC values were compared for statistical significance using De Long test. A p-value of <0.05 was considered statistically significant.Results: Of 81 patients, 15 patients had OF and local complication classified as SAP, with persistent OF (16.0%). The AUC for RS was consistently the highest for predicting mortality (0.943), recurrence of gallstone (0.766), ICU-admission (0.801) and OF (0.852). RS had high specificity (61.9%), PPV (88.2%), Accuracy (90.1%) for predicting mortality, recurrence of gallstone and OF. Glasgow criteria had high sensitivity (85.1%), NPV (79.4) in predicting ICU-admission.Conclusions: RS in comparable with RAC in predicting mortality, GR in patients with GAP and early referral for surgical intervention.

scholarly journals Specific Therapy for Local and Systemic Complications of Acute Pancreatitis With Monoclonal Antibodies Against ICAM-1

1999 ◽  
Vol 229 (6) ◽  
pp. 834 ◽  
Author(s):  
Jens Werner ◽  
Kaspar Z’graggen ◽  
Carlos Fernández-del Castillo ◽  
Kent B. Lewandrowski ◽  
Carolyn C. Compton ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Monoclonal Antibodies ◽  
Specific Therapy ◽  
Systemic Complications ◽  
Local And Systemic Complications

scholarly journals Pancreatic Perfusion CT in Early Stage of Severe Acute Pancreatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Yoshihisa Tsuji ◽  
Naoki Takahashi ◽  
Chiba Tsutomu
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Mortality Rates ◽  
Perfusion Ct ◽  
Clinical Usefulness ◽  
Systemic Complications ◽  
Pancreatic Perfusion ◽  
Local And Systemic Complications

Early intensive care for severe acute pancreatitis is essential for improving SAP mortality rates. However, intensive therapies for SAP are often delayed because there is no ideal way to accurately evaluate severity in the early stages. Currently, perfusion CT has been shown useful to predict prognosis of SAP in the early stage. In this presented paper, we would like to review the clinical usefulness and limitations of perfusion CT for evaluation of local and systemic complications in early stage of SAP.

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