Comparative study of Ranson’s Versus Apache II scoring systems in predicting the clinical outcome in patients with acute pancreatitis

INTRODUCTION: Acute pancreatitis is a common entity encountered during routine surgical practice and it poses a great challenge to the treating surgeon. It is a protean disease capable of wide clinical variation, ranging from mild discomfort to severe consequences. AIMS AND OBJECTIVES: Present study was aimed at analyzing patients admitted to Department of General Surgery, Madurai Medical College with a diagnosis of acute pancreatitis during the period between December 2015 and May 2017 with the following: 1. To assess the severity of acute pancreatitis using Ranson’s scoring system and APACHE II scoring system. 2. To compare these two scoring systems with respect to their accuracy in predicting the outcome in cases of acute pancreatitis. METHODOLOGY: All the 100 patients were subjected to both Ranson’s and APACHE II scoring systems. Scoring was done on admission / time of diagnosis and at 48 hours. The scores were compared with the clinical severity which was graded according to Atlanta criteria and also compared with the clinical outcome. RESULTS: Of the 100 patients, 92 were Male (92.5 %) and 8 were Female (7.5%). There was no statistical significance of Sex (p = 0.545) on the severity of the disease. Of the 100 patients, 92 were Male (92.5 %) and 8 were Female (7.5%). There was no statistical significance of Sex (p = 0.545) on the severity of the disease. Out of 100 patients, 30 (74%) had Alcohol induced Acute Pancreatitis, 3 (8%) had Gall Stones induced Acute Pancreatitis and 7 (18%) had Idiopathic Acute Pancreatitis. There was no statistical significance of Etiology (p = 0.943) on the severity of the disease. Out of 100 patients, 60% had uncomplicated outcome, 40% of patients with any complication, 6.4% of patients developed pseudo cyst, 6% of patients developed Pan – Neurosis, 3 & high paneer. CONCLUSION: The Ranson’s scoring system proved to be as powerful a prognostic model as the more complicated APACHE II scoring system even in the present era of advanced investigations.