Comparison of Ranson, APACHE II and APACHE III scoring systems in acute pancreatitis. Export

@article{citeulike:715172, abstract = {INTRODUCTION: Acute pancreatitis runs an unpredictable course. The early prediction of the severity of an acute attack has important implications for management and timely intervention. AIM: To assess the prognostic accuracy of Ranson and APACHE II and III scoring systems in predicting the severity of acute pancreatitis. METHODS: One hundred fifty-three patients with acute pancreatitis (67.3\% gallstone-related, 9.2\% alcoholic, 17\% idiopathic, and 6.5\% of miscellaneous causes) were studied prospectively. Data conforming to the scoring systems were recorded 24 (the APACHE scores) and 48 hours (the Ranson score) after admission. Analysis was performed by using receiver operating characteristic curves (ROC), area under a curve (AUC), and by comparing likelihood ratios of positive test (LRPT). RESULTS: One hundred nineteen cases of pancreatitis were classified as mild, and 34 were classified as severe. The mortality rate was 3.2\%. All three scores correlated with length of stay and disease severity. AUC for Ranson was found to be significantly larger than AUC for APACHE II and APACHE III score (0.817, cut-off > or =3; 0.618, cut-off, > or =10; and 0,676, cut-off > or =42 respectively). The Ranson score achieved the highest sensitivity and the lowest false-negative rate, but the positive and negative predictive values and LRPT were of similar extent for all three scores. CONCLUSION: The APACHE III offers little, if any, advantage over the APACHE II score. Ranson criteria proved to be as powerful a prognostic model as the more complicated APACHE II and III scoring systems, but with the disadvantage of a 24-hour delay.}, address = {Department of Gastroenterology, University Hospital of Heraklion, Crete, Greece.}, author = {Chatzicostas, C. and Roussomoustakaki, M. and Vlachonikolis, I. G. and Notas, G. and Mouzas, I. and Samonakis, D. and Kouroumalis, E. A.}, citeulike-article-id = {715172}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/12409825}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=12409825}, issn = {1536-4828}, journal = {Pancreas}, keywords = {diagnostico, pancreatite, procurar}, month = {November}, number = {4}, pages = {331--335}, posted-at = {2006-06-29 00:45:03}, priority = {2}, title = {Comparison of Ranson, APACHE II and APACHE III scoring systems in acute pancreatitis.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/12409825}, volume = {25}, year = {2002} }

TY - JOUR ID - citeulike:715172 L3 - citeulike-article-id:715172 N2 - INTRODUCTION: Acute pancreatitis runs an unpredictable course. The early prediction of the severity of an acute attack has important implications for management and timely intervention. AIM: To assess the prognostic accuracy of Ranson and APACHE II and III scoring systems in predicting the severity of acute pancreatitis. METHODS: One hundred fifty-three patients with acute pancreatitis (67.3% gallstone-related, 9.2% alcoholic, 17% idiopathic, and 6.5% of miscellaneous causes) were studied prospectively. Data conforming to the scoring systems were recorded 24 (the APACHE scores) and 48 hours (the Ranson score) after admission. Analysis was performed by using receiver operating characteristic curves (ROC), area under a curve (AUC), and by comparing likelihood ratios of positive test (LRPT). RESULTS: One hundred nineteen cases of pancreatitis were classified as mild, and 34 were classified as severe. The mortality rate was 3.2%. All three scores correlated with length of stay and disease severity. AUC for Ranson was found to be significantly larger than AUC for APACHE II and APACHE III score (0.817, cut-off > or =3; 0.618, cut-off, > or =10; and 0,676, cut-off > or =42 respectively). The Ranson score achieved the highest sensitivity and the lowest false-negative rate, but the positive and negative predictive values and LRPT were of similar extent for all three scores. CONCLUSION: The APACHE III offers little, if any, advantage over the APACHE II score. Ranson criteria proved to be as powerful a prognostic model as the more complicated APACHE II and III scoring systems, but with the disadvantage of a 24-hour delay. IS - 4 JF - Pancreas SN - 1536-4828 AD - Department of Gastroenterology, University Hospital of Heraklion, Crete, Greece. EP - 335 TI - Comparison of Ranson, APACHE II and APACHE III scoring systems in acute pancreatitis. VL - 25 SP - 331 KW - diagnostico KW - pancreatite KW - procurar AU - Chatzicostas, C AU - Roussomoustakaki, M AU - Vlachonikolis, IG AU - Notas, G AU - Mouzas, I AU - Samonakis, D AU - Kouroumalis, EA PY - 2002/11// UR - http://view.ncbi.nlm.nih.gov/pubmed/12409825 ER -