Ramanna Macherla1, Swathi G2
Acute Pancreatitis (AP) is a common disorder with substantial burden on the healthcare system. The clinical course of AP is usually mild and often resolves without sequelae. Early, quick and accurate risk stratification of AP patients would permit evidence-based early initiation of intensive care therapy for patients with Severe AP (SAP) to prevent adverse outcomes and allow treatment of mild AP. Therefore, a reliable risk stratification tool to predict the severity and prognoses of AP is of great clinical importance for the management of this disease.
The aim of the present study is designed to compare the accuracy of BISAP to the traditional multifactorial scoring systems- APACHE II and CTSI in predicting disease severity, PNec and mortality.
MATERIALS AND METHODS
The present prospective observational study is carried out for a period of 2 years. 100 consecutive patients with acute pancreatitis according to inclusion and exclusion criteria were taken and were fully explained regarding the study and written informed consent was taken. Detailed case history and clinical examination was done. Vitals and GCS score were recorded. Necessary laboratory investigations were done. CECT of abdomen was done.
In the present study, among 100 patients, 60% are males and 40% are female patients. Mean age group of patients in present study is 37.82±10.73 years. The commonest aetiology alcohol accounted for 61% cases followed by idiopathic in 20% and gallstones in 16% cases. Severe acute pancreatitis developed in 20% of patients. Pancreatic necrosis developed in 14% of patients. In the present study, mortality is 6%. All the scoring systems are found to be comparable and good in the prediction of severe acute pancreatitis (AUC for BISAP - 0.80, APACHE II - 0.81, CTSI - 0.79). CTSI is more accurate (AUC - 0.96) in predicting PNec when compared to BISAP (AUC - 0.91) and APACHE II (AUC - 0.84). APACHE II is excellent (AUC - 1.00) in predicting mortality.
The present study concluded that all the scoring systems were found to be comparable and good in the prediction of SAP, whereas CTSI is more accurate in predicting PNec and APACHE II was excellent in predicting mortality.