engleski

Accuracy of Scoring Systems in Prediction of Severe Acute Pancreatitis

Introduction: Different scoring systems have been widely used for early recognition of severe acutepancreatitis. Predicting developement of systemic complications is very important to timely initiate adequate treatment and increase the rate of survival. Objectives: To evaluate accuracy of various scoring systems as predicotrs for developement of systemic complications in acute pancreatitis (AP). Patients & Methods: A 150 patients with diagnosis of AP (71 male, median age 63 years, range 20–91 years were admitted to our hospital in a 2-year period. We calculated APACHE II, APACHE III, and SAPS II scores for all patients on the first and third day of admission, Ranson and Balthasar scores according to references. ROC analysis was performed to assess accuracy of scoring systems in differentiation of patients with systemic complications and those without. Results: ROC analysis cofirmed that APACHE II on admission and on the third day (P = 0.039, and P = 0.028, respectively), Ranson (P < 0.001), and Balthasar (P < 0.001) scoring systems can significantly predict patients who will develop systemic complications. The largest AUC were measured for Ranson and Balthasar (0.75, and 0.79, respectively). Cut-off values to differentiate severe from mild cases of disease were APACHE II 9, Ranson 4, and Balthasar C. Analysis of APACHE III and SAPS II did not show statistical significance in prediction of the course of disease. Values of APACHE III and SAPS II on admission differed significantly from values on the third day, but without any diagnostic or prognostic significance. Pancreatology 2011 ; 11:Abstracts :99–227 177 Conclusion: APACHE II, Ranson and Balthasar scoring systems are still valuable predictors of developement of systemic complications in AP.

Acute pancreatits; Scoring systems; Prognosis

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