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Comparison of Harmless Acute Pancreatitis Score with Ranson's Score in Predicting the Severity of Acute Pancreatitis
Hamad Hadi Al-Qahtani1, Mohammed Khurshid Alam2, Muhammad Waheed1
1Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Objective:
To determine the predictability of harmless acute pancreatitis score (HAPS) in determining the severity of acute pancreatitis (AP) and compare it with Ranson's score.
Study Design:
Prospective cohort study.
Place And Duration Of Study:
King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, between January 2012 and December 2015.
Methodology:
All patients admitted with AP at King Saud Medical City, Riyadh, during 2012 - 2015 were studied prospectively. Patients were assessed by HAPS and Ranson's score. Predictability values of the two systems were analysed and compared.
Results:
Out of 116 patients studied, 104 (89.6%) were HAPS positive and predicted to have mild disease. Pancreatitis was mild in 101 (87%) but severe in 3 (2.6%) patients who scored ≥ 3 Ranson's criteria. Among 12 HAPS negative patients, 10 scored ≥ 3 Ranson's criteria and developed severe pancreatitis while 2 (1.7%) with 2 positive Ranson's criteria developed mild pancreatitis. HAPS correctly predicted the disease severity in 101 (87%) patients, a sensitivity of 98% specificity of 77% and accuracy of 96%. Ranson's system predicted correctly in all but took 48 hours for assessment. Statistical analysis showed moderate agreement (Kappa = 0.776, p < 0.001), and positive relation (rs = 0.777, p < 0.001) between the two scores.
Conclusion:
HAPS is effective in rapid identification of patient who will run non-severe course of AP. Assessment can be completed within one hour from presentation. Ranson's score, although more accurate, takes 48 hours to complete.
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