Malathy Dharmarajan, Sundarapandian Ramu
BACKGROUND Acute pancreatitis is a condition which involves a wide variety of clinical signs and symptom. The course of which ranges from a mild self-limiting inflammatory process to a more fulminant course which could involve multiorgan dysfunction and lead to mortality. There are several scoring systems in predicting the severity of acute pancreatitis of which the commonly used are APACHE II and Ranson’s scoring systems. But the usage of these two are still under debate and hence the essential for the study. The aim and objective of the study is to compare the RANSON scoring system with APACHE II in predicting the severity of acute pancreatitis. MATERIALS AND METHODS The present study is a prospective study of 50 cases of acute pancreatitis admitted in Government Tiruvannamalai Medical College Hospital, Tiruvannamalai, during the study period from May 2015 to September 2015. Fifty cases for the purpose of the study were selected on the basis of the nonprobability (purposive) sampling method. CONCLUSION The study includes 50 patients with acute pancreatitis, peak incidence was in the fourth decade with alcohol accounting for 30.3% of the attacks while gallstones accounted for 40.4%. An APACHE II score of ≥10 on admission predicted a complicated outcome in patients with acute pancreatitis with a sensitivity of 100%, specificity of 80%, positive predictive value of 62% and negative predictive value of 100%. Scores below 10 predicted an uncomplicated outcome. On admission APACHE II score was a better predictor of systemic complications (sensitivity 100%) than RANSON score (sensitivity 66.7%). Patients with APACHE II scores>10 benefitted from initial ICU care with aggressive therapy aimed at disease cure and dealing with the complications. Hence APACHE II Scoring can be used as a reliable tool in predicting the severity and prognosis than RANSON scoring in patients with Acute Pancreatitis.
