Role of traditional scoring systems apache 2 and Ranson’s in predicting severity of acute pancreatitis

Abstract

Introduction: Acute pancreatitis is a commonly encountered disease in general practice. Acute pancreatitis is an acute inflammatory process of the pancreas with varying involvement of other regional tissues or remote organ systems. In 1889 Reginald Fitz gave the classic clinical and pathological description of acute pancreatitis. The incidence of acute pancreatitis per 100,000 population ranges from 5.4 to 79.8 cases per year. Materials and methods: The present study was an observational retrospective study. 22 diagnosed cases of acute pancreatitis admitted in Silchar Medical College and Hospital (medicine and surgery department) were included in study. Study period was from 1st January 2020 to 31st March 2020. The required lab investigations and clinical parameters were evaluated and RANSON’S and APACHE 2 scoring was done. The final scores of the patients from both the scoring systems were assessed to know their efficacy in predicting the severity of the disease. Results: Out of 22 patients 13(59.09%) were men and 9(40.97%) were women. The causes of acute pancreatitis included billiary stone 9(40.97%), alcoholism 7(31.81%), idiopathic 6(27.27%). Out of 22 patients admitted, 5 patients eventually went on to develop severe acute pancreatitis in the form of systemic and local complications. According to Ranson’s score 2 patients had score >3 suggesting that only 9.09% were considered severe pancreatitis. Conclusion: APACHE 2 scoring system had a better predicting value as compare to Ranson’s score. APACHE 2 was more easier to perform quick and accurate as compare to Ranson’s for predicting complications. Patients with APACHE 2 score >10 benefited by initial ICU care and aggressive therapy. Hence APACHE 2 scoring can be used as a reliable tool in predicting severity of acute pancreatitis as compared to Ranson’s scoring.