Abstract

Outcome in Acute Pancreatitis – An Evaluation of Prognostic Efficacy of Clinical Staging versus CT Severity Index

Objective Acute pancreatitis presents a broad clinical spectrum ranging from cases so mild that symptoms abate before the diagnosis is actively pursued, to cases which progress rapidly to multisystem failure and eventual demise of patient despite current mode of therapy. Methods A retrospective study of 50 patients diagnosed as acute pancreatitis was done. Patients suffering from acute pancreatitis due to any cause, in any age group, of either sex, were taken in the study. Blood samples were collected at time of admission and at 48 hours. All CT examinations were performed on SOMATOM ART Seimens machine. Grading was done according to Ranson s criteria, APACHE II and CTSI. Results There is statistical difference in the accuracy of CTSI and Ranson or APACHE II when mortality was taken into account. CTSI has accuracy (94%) significantly more than Ranson and APACHE II. In present study accuracy of Ranson and APACHE II is equal (84%) but Ranson has very less sensitivity in predicting the mortality. So CTSI has the best prognostic value in predicting the outcome of patients with acute pancreatitis. Conclusion CTSI is the best scoring system in predicting mortality in patients with acute pancreatitis. Ranson and APACHE II have almost equal efficacy in predicting mortality but less than efficacy of CTSI. For predicting cure of the patients APACHE II is the most sensitive criteria but its specificity is very less. CTSI has maximum specificity and overall accuracy in predicting whether patients will be cured or relapsed.


Author(s):

Bikramjit Singh, Navneet Kaur



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