Abstract
Introduction: The purpose of the study was to compare different parameters used in Ranson’s Criteria, Bedside
Index of Severity in Acute Pancreatitis (BISAP), Acute Physiology and Chronic Health Evaluation (APACHE-II),
and modified computed tomography severity index (MCTSI) for predicting the severity of acute pancreatitis and
formulate a new scoring system to assess the severity of acute pancreatitis based on their prognostic severity
index in the local population.
Materials and Methods: This prospective pilot study was conducted at Rawalpindi Medical University allied
hospitals from August 2019 to December 2019. All patients with a diagnosis of acute pancreatitis were included in
the study through non-probability convenient sampling. Different scoring parameters were entered into
standardized proforma.
Results: 100 patients were included in the pilot study with a mean age of 46.53 ± 15.324. Among 24 parameters
from APACHE-II, Ranson’s, BISAP, and MCTSI, only 11 parameters, Pleural effusion (PE), Pancreatic necrosis
(PN), LDH, serum Calcium (Sca++), Pulse, GCS, MCTS1, Base deficit, Po2, BUN-24 and BUN-48 were
significantly related(at 10% level of significance) with the severity of acute pancreatitis. Similarly out of 24, 10
parameters AST, LDH, Sca++, Pulse, PE, PN, Base deficit, MCTS1, Po2, and BUN 48were significantly covered
more than 50% of the area in AUC analysis. Our proposed criteria based on 9 parameters LDH, Sca++, Pulse, PE,
PN, Base deficit, MCTS1, Po2, and BUN 48which were blowing by the two methods (ANOVA and ROC). The
sensitivity and specificity were higher with our proposed criteria 93.1% and 60.6%respectively as compared to the
Ranson’s, modified Ranson, BISAP, and APACHE-II criteria.
Conclusion: The newly proposed criteria for the assessment of the severity of AP is superior as compared to old
criteria.
Tanveer Hussain, Muhammad Hanif, Ramlah Ghazanfor, Sarmad Arslan, Muhammad Umar, Ibia Nawaz. (2020) Acute Pancreatitis severity scoring index: Prospective study to identify determinants in Pakistan, The Journal of Rawalpindi Medical College, Volume 24, Issue 3.
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