Arunabha Sinha 1 , Nitin Kumar Kamble 2 , Vinayak Vajpeyi 3 , Kirthana Babu Reddy 4 , Swathi Galidevara
BACKGROUND Acute pancreatitis is defined as an acute condition presenting with abdominal pain and is usually associated with raised pancreatic enzyme levels in the blood or urine as a result of pancreatic inflammation. Acute pancreatitis can be classified as mild or severe. The aim of the study is to assess the accuracy of Ranson’s score, APACHE score, Glasgow severity scale, PANC 3 score in predicting the severity of acute pancreatitis. MATERIALS AND METHODS A prospective study was done for a period of two years from November 1, 2013, to October 31, 2015, in patients diagnosed as acute pancreatitis. A detailed history and physical examination was carried out and diagnosis of acute pancreatitis was made. All the study cases underwent relevant investigations. Based on the results, the Ranson’s score, APACHE II score, Glasgow severity score and PANC 3 score were calculated. The APACHE II was taken as gold standard scoring system and other severity scores were compared to it. RESULTS In our study of 60 patients, the sensitivity of Ranson’s criteria was greatest (100%), then followed by Glasgow severity index and PANC 3 criteria. The specificity and PPV was greatest for PANC 3 criteria. The NPV was highest for Ranson’s, while the accuracy in predicting acute pancreatitis was highest for Glasgow severity index. CONCLUSION Acute pancreatitis can present in mild and severe form, mainly a clinical diagnosis supplemented by biochemical and radiological findings. It is extremely important to differentiate severe form of acute pancreatitis from the mild form, so that appropriate intensive treatment can be started in cases of severe pancreatitis. Ranson and Glasgow severity index required multiple data and the patient had to be evaluated after 48 hours to get a clear picture of the severity of the acute pancreatitis. The Ranson’s had the highest sensitivity and NPV. The PANC 3 criteria was cost-effective and time saving. It had highest specificity and PPV in our study. We can conclude from our study that the PANC 3 criteria can be used not as a substitute, but as a method to be used in combination with Ranson’s criteria because of its high specificity, PPV and accuracy.
