COMPARISON OF 24 HOUR APACHE-II, BISAP AND POP SCORES IN PREDICTING OUTCOMES IN ACUTE PANCREATITIS

Dr. Sami Anwar Khan; Dr. Selvakumar Balakrishnan; Dr. Shalu Gupta

Volume : VIII, Issue : III, March - 2019

COMPARISON OF 24 HOUR APACHE-II, BISAP AND POP SCORES IN PREDICTING OUTCOMES IN ACUTE PANCREATITIS

Dr. Sami Anwar Khan, Dr. Selvakumar Balakrishnan, Dr. Shalu Gupta

Abstract :

Acute Pancreatitis(AP) is a disease of variable clinical presentation, with an uneventful course in a majority and a significantly morbid course(severe AP) in about 20% cases1. In severe AP, the mortality is about 20 – 25%2. Predicting patients likely to develop severe AP at admission and early intensive care(ICU) likely leads to a better therapeutic outcome as a > 24hours delay in ICU shifting leads to a four–fold increase in mortality5. The multifactorial Acute Physiology and Chronic Health Evaluation(APACHE) – II score is widely considered the �gold standard�6 against which newer systems are evaluated. Recently two new simple systems appear promising in initial studies: the bedside index of severity assessment in acute pancreatitis(BISAP) and the pancreatitis–outcome prognostication(POP) score8,9,10. We compared these three scores to find out which score predicts closest to outcomes of AP. It was found that BISAP and POP scores can predict the adverse outcomes of AP viz., persistent organ failure, Panctratic Necrosis or in–hospital mortality as accurately as APACHE–II score. The cut–offs of these scores that definitively predict a given adverse outcome needs to be established in further studies. Of the 3 outcomes, Pancreatic Necrosis was less accurately predicted by all the 3 scores as compared to persistent organ failure or mortality.