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ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2003, Number 2

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Cir Gen 2003; 25 (2)

Comparison of two prognostic scoring systems of multiple parameters (APACHE II and Ranson) in acute pancreatitis

Duffy-Verdura BE, Mijares GJM, Ortega CL, Pérez TH, Cárdenas LLE

Language: Spanish
References: 19
Page: 112-118
PDF size: 58.99 Kb.


ABSTRACT

Objective: To assess the efficacy of the APACHE II and Ranson scoring systems to predict the severity of acute pancreatitis.
Design: Prospective, observational, comparative, open, longitudinal study.
Setting: Third level health care hospital.
Patients and methods: Two-hundred-ten patients with a diagnosis of acute pancreatitis were studied. APACHE II and Ranson scoring system were applied to each patient at admittance and after 48 hours. We determined the predictive (positive and negative) values, sensitivity and specificity of both systems to predict the severity of the event, taking as golden standard major morbidity and mortality.
Results: Sensitivity of the Ranson system to predict major morbidity was of 64.7%, specificity was of 81.81%, and efficacy of 79.04%. The APACHE II system at admittance revealed a sensitivity of 23.52% and a specificity of 89.20%. Positive and negative prediction values for morbidity were of 29.63 and 85.79%, respectively. Sensitivity of APACHE II at 48 hours to predict the occurrence of major complications was of only 26.47%, whereas specificity was of 93.75%. The positive prediction value of this system was of 45%.
Conclusion: The Ranson system had a greater sensitivity and positive prediction value. APACHE II at admittance and after 48 hours only depicted a better specificity.


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