The Clinical Prognostic Indicatorsof Acute Pancreatitis byApache II Scoring

摘要

Background and Objectives: Acute pancreatitis is a catastrophic condition with many complications and poses a great challenge to the treating surgeon. 10-20% of the patients who develop complications will not recover with simple supportive therapy. Hence, an accurate prediction of severity and prognostic monitoring are necessary to anticipate the early and late complications, so as to consider aggressive treatment. The present study aimed at predicting the prognosis in patients with acute pancreatitis by using the APACHE II scoring system and at determining the utility of these scores in further management.Methods and Material: 51 patients who were admitted to the AJ Institute of Medical Sciences with the clinical and radiologicalevidence of acute pancreatitis, with an elevation in the serum amylase levels, were the subjects of this study.Results And Interpretation: The mean APACHE II scores were 6.62 and 11 in 32 uncomplicated cases and 19 complicated cases respectively.4 complicated patients who died eventually had scores which were persistently above 14. Sequential variations in the APACHE II scores correlated with the patient outcome.Conclusion: The APACHE II scores which are calculated on admission accurately predict the outcome of the patients with acute pancreatitis. This scoring system is superior to other systems like Ranson?s criteria, because it takes into account all the major risk factors that influence the patient outcome.