[Development of prognostic systems in acute pancreatitis]

Acute pancreatitis is an illness of unpredictable course and in order to implement optimal treatment requires quick assessment of its probable severity and course. The development of prognostic systems was caused to determine patients of high risk of severe course of the illness, that require intensive care and proper treatment. This is the reason of development of prognostic systems based on clinical criteria, lab results and imaging procedures. Yet, none of them does fulfill all requirements. In the paper author presented and evaluated the clinical usefulness of various methods of predicting the course of pancreatitis in historical view. Although commonly used are multifactor clinical scales, current literature shows changing requirements to any scale evaluating the illness that come from better knowledge of biological mechanisms and technological development. Yet still commonly used are simple and and of practical use in any hospital ward multifactor scale with additional C-reactive protein assessment. Based on these there is high probability of correct assessment the future course of acute pancreatitis within 48 hours. Important element of evaluation of pancreatitis is current level of morphological distortion and pancreatic necrosis with use of computed tomography with contrast used in CTS index. The ultimate outcome of our assesment would be the result of the treatment of acute pancreatitis that is dependant on the skill of predicting the severity of illness course and in the end optimal treatment of the patient