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Published on: June 28, 2021
[Prognosis of acute pancreatitis: Ranson or APACHE II?]
J P Paredes Cotoré1, M Bustamante Montalvo, E Fernández Rodríguez
1Servicio de Cirugía General, Hospital General de Galicia, Facultad de Medicina, Universidad de Santiago de Compostela.
Objective:
The aim of this paper is to determine which is the best early prognostic score in acute pancreatitis among those we have studied.
Design:
Prospective study of acute pancreatitis cases during a 5 year period.
Patients:
113 patients, biliary etiology in 93 cases, (average age: 63 years) and 66% females. The diagnostic accuracy of Ranson, Imrie, Osborne and apache II scores was analyzed.
Results:
There were complications in 12%, and mortality was 8%. Among all the systems analyzed the Ranson criteria achieved the highest sensitivity (79%), although sensitivity was improved with Apache II at admission to the hospital (86%). We have obtained the best specificity with the Apache II (89%) and with the Osborne criteria (88%). The modification of Ranson's criteria for biliary etiology didn't improve the sensitivity (56%) to detect severe cases of acute pancreatitis.
Conclusions:
The Apache II system was the best for the early detection of severe acute pancreatitis. Its diagnostic sensitivity was higher than the multiple laboratory criteria analyzed.
Related Concept Videos
Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Acute Pancreatitis II: Clinical Manifestations and Management
Chronic Pancreatitis II: Collaborative Care
Assessment:
Acute Pancreatitis I: Introduction
Acute Pancreatitis II: Pathophysiology
Chronic Pancreatitis I: Introduction

