Early prediction of severity and outcome of acute severe pancreatitis

摘要

Objective: To establish the value of APACHE II scoring system, C-reactive Protein (CRP) level and C.T Severity Index (CTSI) in predicting the severity of acute pancreatitis. Methodology: A prospective study was done in the Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, over a period of one year i.e. from January to December 2007. Fifty patients of acute pancreatitis were taken and their outcome and severity was assessed by using APACHE II score, CRP level and CTSI. Results: At the end of the study results showed that thirty eight (76%) patients were young females, most of which had gall stone pancreatitis, twenty-one patients (42%) had severe acute pancreatitis, twenty two (44%) patients had length of hospital stay of two or more than two weeks, in 21 patients (42%) patients APACHE II score was more than 8, in 21 patients (42%) CRP level was more than 120mg/l, CTSI showed that eighteen (36%) had three points and three (6%) had four points. Three patients (6%) expired within 72 hours of admission due to advanced age, uncontrolled sepsis and co-morbids. Conclusion: The severity markers used in this study showed significant importance in prediction of severity of acute pancreatitis. Particularly Apache II scoring system and CTSI.