Comparison between Acute Physiology and Chronic Health Evaluation II and Ranson’s scores in prognosis of acute pancreatitis

Objective
Our aim was to compare the efficacy of Acute Physiology and Chronic Health Evaluation (APACHE) II and Ranson’s scores in detecting the severity and prognosis of acute pancreatitis in a tertiary care hospital in Menoufia, Egypt.
Patients and methods
A total of 30 cases diagnosed as acute pancreatitis were admitted to our hospital during the period from March 2017 to July 2019. APACHE-II and Ranson’s scores were calculated for all the cases. The best cutoffs for both scores and the area under the curve were estimated based on the receiver operating characteristics curve, and both scores were compared prospectively.
Results
The total number of patient selected for the tests was 30 patients. The mean age was 52.4 years, with range from 19 to 80 years. Females represented most cases (70%), with dominance of females in the Ranson’s score. All patients showed pain in the epigastric region (100%) as a first symptom to start the scoring system. We found high accuracy, sensitivity, and specificity of APACHE-II score at cutoff point of 8.4 (92, 97, and 84%, respectively) compared with Ranson’s score at cutoff point of 3.1, which shows less accuracy, sensitivity, and specificity (86, 90.4, and 82.4%, respectively), with significant value of 0.001.
Conclusion
APACHE-II can be a suitable score in detecting patients who are suspected to have severe disease early from the start of their disease illness, and it may be better than Ranson’s score in this concern.