A Comparative Study of Ranson’s Criteria and APACHE II Scoring System in Prediction of Severity in the Patients of Acute Pancreatitis

Abstract

Introduction: Acute pancreatitis (AP) is an inflammatory
process due to auto-digestion of the gland by pancreatic
digestive enzymes, leading to impairment of function or any
morphologic changes. It can re-occur intermittently, contributing
to ongoing insult, referred to as ‘Chronic Pancreatitis’ (CP).
Severe AP (SAP) develops in about 25.0% of patients with
AP. The average mortality rate in SAP approaches 2.0–10.0%.
Materials and Methods: This prospective, comparative
study was conducted in the Department of General Surgery
in a Tertiary Care Hospital of North India from 01.02.2021 -
31.07.2022 in SRMSIMS, Bareilly, U.P. A total of 105 patients
were evaluated using RANSON’S and APACHE criteria when
presented with a clinical history of pain abdomen. After due
consent from the patients, the demographic details, clinical
examination, laboratory and radiological Investigations, and
final diagnosis were noted during the hospital stay.
Results: In our study, which was reported for acute pancreatitis
sensitivity, specificity and accuracy of Ranson’s score, it was
found that 75.0, 67.01 and 67.6% and that for APACHE II is
92.31, 82.28 and 84.76% sensitivity, specificity and accuracy
of APACHE II score, respectively
Conclusion: According to our study, APACHE II scoring was
found to be more sensitive and specific than RANSON’S score
to predict better prognosis in patients of acute pancreatitis