Title: A Comparative Study of Assessment of Different Parameters for Assessing Severity of Acute Pancreatitis
Authors: Pawan Kumar Jha, Rajnish Chandran, Pradeep Jaiswal, Kumari Seema
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.76
Abstract
Introduction: The need for assessing the severity of acute pancreatitis is because the management and prognosis are mainly decided by the severity of the disease. A parameter with high positive predictive value and accuracy which could be best correlated with clinical course, severity and identifies the local extent and complications, is beneficial for proper planning and management of the patient.
Materials and Methods: This was a prospective study conducted over 2 years period on admitted cases of acute pancreatitis. Total 157 patients were selected for study. All data regarding APACHE II Score, CT severity index and C - reactive protein parameter for assessing the prognosis of acute pancreatitis were analysed to find out best indicator.
Results: According to APACHE II scoring system 73.2% categorised as mild whereas 26.8% into severe groups. As per CT severity index, 79% patients were categorised in mild and 21 % in severe group. CRP level showed 61.7% in mild group whereas 38.3% in severe group. In our study CT Severity index showed highest sensitivity (84.2%), specificity (97.4%), positive predictive value (91.4%) negative predictive value (95%) and accuracy (94.2%), compared to APACHE II score and CRP levels.
Conclusion: The comparative study between different scoring systems, CTSI had the highest PPV, NPV, sensitivity, specificity and accuracy and best correlated with the clinical course of the disease and was able to detect the extent of local inflammation and the occurrence of local complications.
Keywords: Acute Pancreatitis, Atlanta classification, APACHE II score, CT Severity Index, C - reactive protein.
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