Comparison of ranson and apache ii scoring system in prediction of severity in patients of acute pancreatitis presenting in rural hospital in central india

Background: Acute pancreatitis is one of the commonest disorder in surgical practice. Numerous advances have been made in diagnosis and treatment of acute pancreatitis. Predicting outcome in these cases still remains difficult. Multiple scoring systems have been developed to predict its severity. Aim: This study was aimed at comparing the traditional scoring systems: Ranson’s and Acute Physiology and Chronic Health Examination (APACHE II) in predicting severity in a prospective cohort of patients with Acute Pancreatitis. Material and methods: The study comprised of 144 patients of acute pancreatitis. According to the Atlanta classification the patients were classified into having mild or severe acute pancreatitis. Ranson score and APACHE II score were used for predicting the severity of acute pancreatitis. Samples were analysed and data analysed. Results: Out of the 144 cases of acute pancreatitis, 39 had severe acute pancreatitis, correlating with APACHE II score ≥8, 54 had mild acute pancreatitis with score <8. 24 had severe acute pancreatitis, correlating with Ranson score ≥3, 70 had mild acute pancreatitis with score <3. AUC curve for 24 hours APACHE II score was larger than AUC curve for RANSON score and the difference was found to be statistically significant (p<0.01). Conclusion: APACHE-II scoring system seems to have the highest accuracy in assessment of the severity and outcome of Acute Pancreatitis, and appeared to be a more influential tool than Ranson Score, however Ranson score was better in predicting complications of pancreatitis.