A comparative study on four clinical criteria in the prediction of severity of acute pancreatitis

Objective To assess the accuracy of four clinical diagnostic criteria systems[Ranson,Glasgow,APACHEⅡ and Balthazar CT severity index(CTSI)] in the prediction of severity acute pancreatitis. Methods Two hundreds and thirty eight patients with acute pancreatitis were retrospectively studied with these four criteria systems.Clinical criteria of four systems together with the duration of fasting and hospitalization were analyzed.The sensitivity and specificity of severe acute pancreatitis of these four systems were assessed.Using receiver operating characteristic(ROC) curves. Results Among 238 patients,mild pancreatitis was identified in 189 patients,and severe pancreatitis in 49 patients.The mean scores of Ranson,Glasgow,APACHEⅡ,CTSI between mild pancreatitis and severe pancreatitis were statistical and significant difference(p0.01).The scores of the four systems were correlated significantly with days of fasting and hospitalization.The sensitivity of CTSI system was the highest(83.67%) and largest AUC(0.91) in predicting acute pancreatitis outcomes.APACHEⅡ(48h) system had the highest specificity. Conclusion CDSI is more useful in predicting acute pancreatitis and comprehensive assessment can improve the accuracy in predicting the severity of the disease.