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A Comparative Study on Prognostic Relevance of Various Severity Scoring Systems of Acute Pancreatitis in Present Day Surgical Practice

Original articles

Abstract

Prior assessment of severity is very important in the management of acute pancreatitis. The purpose of our study is to compare the predictive efficacy of various severity scoring systems for acute pancreatitis. This  study  was  conducted  in  patients  admitted  with  acute pancreatitis  in  Medical  College Kolkata, between  January 2011 to  November  2011  by  doing  a  prospective  analysis  of  patients’  case  notes. There was no significant difference in median APACHE II score on admission and after 48 hours in our study.  Ranson’s  and  APACHE II  score  was  found  to  have similar  sensitivity  and   negative  likelihood  ratio. Ranson’s and CTSI had similar PPV and PLR.  Ranson’s  score  proved  equal  to  the  APACHE  II  score  for  predicting  mortality  and  the  development  of  organ  dysfunction. The LR+ of MGMOF score (cut off at ≥2) after 48 hours, MGMOF score (cut off at ≥2) on admission,   MGMOF score >0 after 48 hours and on admission and Ranson’s were almost comparable. All the scores under study except Goris MOF at a cut off  ≥2 on admission had good predictive value in terms of different predictive accuracy parameters. CTSI and Ranson’s score can be most useful to identify mild  pancreatitis  cases but  can  also  be  useful  in  severe  pancreatitis  patients  to  some  extent. However, Ranson’s score can not be applied for prediction of severity after 48 hours.