PROGNOSIS OF ACUTE-PANCREATITIS - RANSON OR APACHE-II

Objective: The aim of this paper is to determine which is the best early prognostic score in acute pancreatitis among those we have studied. Design: Prospective study of acute pancreatitis cases during a 5 year period. Patients: 113 patients, biliary etiology in 93 cases, (average age: 63 years) and 66% females. The diagnostic accuracy of Ranson, Imrie, Osborne and apache II scores was analyzed. Results: There were complications in 12%, and mortality was 8%. Among all the systems analized the Ranson criteria achieved the highest sensitivity (79%), although sensitivity was improved with Apache II at admission to the hospital (86%). We have obtained the best specificity with the Apache II (89%) and with the Osborne criteria (88%). The modification of Ranson's criteria for biliary etiology didn't improve the sensitivity (56%) to detect severe cases of acute pancreatitis. Conclusions: The Apache II system was the best for the early detection of severe acute pancreatitis. Its diagnostic sensitivity was higher than the multiple laboratory criteria analyzed.