Comparative Analysis of Scoring Systems for Predicting Mortality in Acute Pancreatitis

Background: Acute pancreatitis is usually a mild and self-limiting disease. About 25 % of patients have severe episode with mortality up to 30%. Early identification of these patients has potential advantages of aggressive treatment at intensive care unit or transfer to higher centre. Several scoring systems are available to predict severity of acute pancreatitis but are cumbersome, take 24 to 48 hours and are dependent on tests that are not universally available. Haematocrit has been used as a predictor of severity of acute pancreatitis but some have doubted its role.Objectives: To study the significance of haematocrit in prediction of severity of acute pancreatitis.Methods: Patients admitted with first episode of acute pancreatitis from February 2014 to July 2014 were included. Haematocrit at admission and 24 hours of admission were compared with severity of acute pancreatitis. Mean, analysis of variance, chi square, pearson correlation and receiver operator characteristic curve were used for statistical analysis.Results: Thirty one patients were included in the study with 16 (51.61%) male and 15 (48.4%) female. Haematocrit at 24 hours of admission was higher in severe acute pancreatitis (P value 0.003). Both haematocrit at admission and at 24 hours had positive correlation with severity of acute pancreatitis (r: 0.387; P value 0.031 and r: 0.584; P value 0.001) respectively.Area under receiver operator characteristic curve for haematocrit at admission and 24 hours were 0.713 (P value 0.175, 95% CI 0.536 - 0.889) and 0.917 (P value 0.008, 95% CI 0.813 – 1.00) respectively.Conclusion: Haematocrit is a simple, cost effective and widely available test and can predict severity of acute pancreatitis.Journal of Kathmandu Medical College, Vol. 4(1) 2015, 3-7

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Accuracy of conventional and novel scoring systems in predicting severity and outcomes of acute pancreatitis: a retrospective study

Lipids in Health and Disease ◽

10.1186/s12944-021-01470-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Qing Wu ◽

Jie Wang ◽

Mengbin Qin ◽

Huiying Yang ◽

Zhihai Liang ◽

...

Keyword(s):

Acute Pancreatitis ◽

Organ Failure ◽

Scoring System ◽

Characteristic Curve ◽

Failure Prediction ◽

Scoring Systems ◽

Mortality Prediction ◽

Severity Prediction ◽

Index Of Severity ◽

Glasgow Score

Abstract Background Recently, several novel scoring systems have been developed to evaluate the severity and outcomes of acute pancreatitis. This study aimed to compare the effectiveness of novel and conventional scoring systems in predicting the severity and outcomes of acute pancreatitis. Methods Patients treated between January 2003 and August 2020 were reviewed. The Ranson score (RS), Glasgow score (GS), bedside index of severity in acute pancreatitis (BISAP), pancreatic activity scoring system (PASS), and Chinese simple scoring system (CSSS) were determined within 48 h after admission. Multivariate logistic regression was used for severity, mortality, and organ failure prediction. Optimum cutoffs were identified using receiver operating characteristic curve analysis. Results A total of 1848 patients were included. The areas under the curve (AUCs) of RS, GS, BISAP, PASS, and CSSS for severity prediction were 0.861, 0.865, 0.829, 0.778, and 0.816, respectively. The corresponding AUCs for mortality prediction were 0.693, 0.736, 0.789, 0.858, and 0.759. The corresponding AUCs for acute respiratory distress syndrome prediction were 0.745, 0.784, 0.834, 0.936, and 0.820. Finally, the corresponding AUCs for acute renal failure prediction were 0.707, 0.734, 0.781, 0.868, and 0.816. Conclusions RS and GS predicted severity better than they predicted mortality and organ failure, while PASS predicted mortality and organ failure better. BISAP and CSSS performed equally well in severity and outcome predictions.

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Comparison of three Glasgow multifactor prognostic scoring systems in acute pancreatitis

British Journal of Surgery ◽

10.1002/bjs.1800750519 ◽

1988 ◽

Vol 75 (5) ◽

pp. 460-462 ◽

Cited By ~ 41

Author(s):

T. Leese ◽

D. Shaw

Keyword(s):

Acute Pancreatitis ◽

Scoring Systems ◽

Prognostic Scoring Systems

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Sa1468 Myriads of Markers and Scoring Systems for Multiple Events in Acute Pancreatitis………Which Do We Mix and When Do We Match….

Gastroenterology ◽

10.1016/s0016-5085(12)61175-5 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-314 ◽

Cited By ~ 2

Author(s):

Sreekanth Appasani ◽

Ragesh B. Thandassery ◽

Indrajit Abujam ◽

Thakur D. Yadav ◽

Kartar Singh ◽

...

Keyword(s):

Acute Pancreatitis ◽

Scoring Systems ◽

Multiple Events

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Comparative analysis of different methods of anesthesia in patients with acute pancreatitis using pain scales

Kazan medical journal ◽

10.17750/kmj2016-217 ◽

2016 ◽

Vol 97 (2) ◽

pp. 217-221

Author(s):

V N Shilenok ◽

E V Nikitina

Keyword(s):

Acute Pancreatitis ◽

Comparative Analysis ◽

Visual Analogue Scale ◽

Pain Intensity ◽

Epidural Anesthesia ◽

Analogue Scale ◽

Pain Syndrome ◽

Opioid Analgesics ◽

Inflammatory Drugs ◽

Anti Inflammatory

Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.

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Clinical pattern of acute pancreatitis in eastern India and comparison of Ranson, BISAP and APACHE II as a predictor of severity, local complications and mortality

International Surgery Journal ◽

10.18203/2349-2902.isj20184649 ◽

2018 ◽

Vol 5 (11) ◽

pp. 3707 ◽

Cited By ~ 1

Author(s):

Nishith M. Paul Ekka ◽

Gaurav Mishra ◽

Vinod Kumar ◽

Arun Kumar Tiwary ◽

Tanushree Kar ◽

...

Keyword(s):

Acute Pancreatitis ◽

Serum Amylase ◽

Hospital Admissions ◽

Scoring Systems ◽

Apache Ii ◽

Aetiological Factor ◽

Serum Lipase ◽

Clinical Pattern ◽

Local Complications ◽

Complications And Mortality

Background: Acute pancreatitis is the single most frequent gastrointestinal cause of hospital admissions. Scoring systems have been used since the 1970s for assessment of its severity. This study was aimed to assess the clinical pattern of acute pancreatitis and to compare various predicting systems like Ranson, BISAP and APACHE II in predicting severity, local complications and mortality in acute pancreatitis.Methods: In this prospective study, 91 consecutive cases of acute pancreatitis admitted, between April 2015 to March 2017, were studied. The diagnostic criteria include the presence of at least two of the three features; abdominal pain, serum amylase and lipase levels and findings on imaging studies. Patients were divided into two groups each, BISAP Ranson ≥3 and <3, APACHE II ≥8 and <8, and analyzed statistically.Results: Out of total of 91 patients, 81 were male and 14 were female with mean age was 36.14 years. Commonest aetiological factor was alcoholism in 57.89% followed by gallstones in 23.16%. Serum amylase was raised in 83.26% patients while 95.79% had raised serum lipase levels. 75.79% patients were of MAP while 24.21% patients were of MSAP and SAP. 7.37% patients developed local complications and mortality rate was 6.32%. All the scoring systems were found similar in predicting severity, local complication and mortality, had low sensitivity and high specificity (P value < 0.05).Conclusions: There is no ideal predicting system for acute pancreatitis. These scoring systems can be used to triage patients for better healthcare delivery.

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