European Journal of Molecular & Clinical Medicine

Abstract

Background: Severe acute pancreatitis is characterized by short course, progressive multi-organ dysfunctions (MODS), early hypoxemia, necrosis, infection, sepsis, and abdominal compartment syndrome which are the major determinants of mortality in acute pancreatitis. The current study aims to assess the severity of acute pancreatitis by using BISAP (Bedside Index for Severity in Acute Pancreatitis) and APACHE-II (Acute Physiology and Chronic Health Evaluation) scoring systems.
Methods: After the admission of the patient data was collected by history taking, complete physical examination. Appropriate radiological investigations were X-ray Abdomen, USG abdomen, CT scan, Balthazar and CT Severity Index (CTSI), Chest X-ray PA view, and MRI if required. Laboratory investigations included Complete blood count, serum electrolytes, renal function tests, liver function tests PT-INR, HbsAg, HIV, serum amylase, serum lipase, serum calcium, and Arterial blood gas analysis.
Results: When the cutoff values of APACHE II were taken at 10 the sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) calculations were 88.56%, 95.51%, 88.64% and 92.32%.  Similarly, for the BISAP Scoring system when the cutoff values of 3 were taken the sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were 91.25%, 82.31%, 72.52% and 94.03%.
Conclusion: The comparison between BISAP and APACHE II scores in our study did not reveal the superiority of any scoring system over the other statistically. However, there are several advantages and disadvantages of each. The APACHE II has advantages like being able to assess the condition accurately on admission and scores of > 10 indicate mortality risk. Whereas the BISAP is better since it uses clinical findings and imaging to derive five-point scores and values of > 3 indicate increased mortality risk.