Assessment of severity in acute pancreatitis: Use of prognostic factors

This prospective study evaluates the value of Ranson's prognostic factors in predicting severity of acute pancreatitis. One hundred-fourteen patients with 124 attacks of acute pancreatitis were studied duringa 4-year period at Riyadh Central Hospital. The majority of patients were Saudi males, their mean age being 46.5 years. Cholelithiasis was the leading cause of pancreatitis. Ranson's 11 prognostic factors were estimated within 48 hours of admission. Sixty-six percent of the cases were graded as mild pancreatitis with less than 3 Ranson's factors present, whereas 34% were classified as severe pancreatitis with 3 or more of Ransosn's factors present. Prognostic factors correctly predicted severity in 6% of patients, but only 36% from the severe group developed severe disease (complications and/or death). Overall mortality was 5.3%. Ranson's prognostic factors help in identifying severe pancreatitis but their accuracy may be improved by the use of modern imaging techniques.