Scoring Systems to Predict the Severity of Acute Pancreatitis-A Review

Authors: Prasanna G*, Thirunavukkarasu VS and Gokul DY

DOI: DOI: 10.23880/ijsst-16000140

Volume 4, Issue 1

Abstract

Acute pancreatitis is a common and recurrent disorder, where inflammation of the pancreas with inconstant connection of other surrounding tissues or other organ systems. This condition is characterized by long-term pain in the abdomen area, frequent exacerbations of the disease, and insufficiency of the exocrine and/or endocrine. Among the individuals with pancreatitis, identification of patients who are at risk of severe disease and mortality is a crucial step for the purpose of effective management and prevention of mortality. Numerous scoring systems are present to help assess disease severity and prognosis. Materials and methods: In this review, 22 original research articles and 1 meta-analysis study comparing the different types of scoring systems have been scrutinized and their outcome understood. Results: While pitfalls were identified in various scoring systems, a generalised outcome from all the studies show that BISAP scoring has good specificity but inadequate sensitivity in predicting disease outcome. APACHE 2 has good predictive value in assessing SAP. EPIC scoring system was found to be a good predictor of organ damage. Modified CTSI also has good predictive value for SAP. Conclusion: While the results show that APACHE 2, BISAP scoring, Modified CTSI and Ranson’s scoring are the most frequently used and have the best specificity and sensitivity among the various scoring systems, it is of our opinion that similar large studies need be conducted in a south Indian population, in order to better understand the implications of the change in race and food habits of the study population and usefulness of the same scoring systems in ascertaining the prognosis of pancreatitis when compared to the rest of the world.

Keywords: Pancreatitis; Scoring System; APACHE 2; BISAP; Modified CTSI; EPIC

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