[Prognosis of acute pancreatitis: Ranson or APACHE II?].
OBJECTIVE
The aim of this paper is to determine which is the best early prognostic score in acute pancreatitis among those we have studied.


METHODS
Prospective study of acute pancreatitis cases during a 5 year period.


METHODS
113 patients, biliary etiology in 93 cases, (average age: 63 years) and 66% females. The diagnostic accuracy of Ranson, Imrie, Osborne and apache II scores was analyzed.


RESULTS
There were complications in 12%, and mortality was 8%. Among all the systems analyzed the Ranson criteria achieved the highest sensitivity (79%), although sensitivity was improved with Apache II at admission to the hospital (86%). We have obtained the best specificity with the Apache II (89%) and with the Osborne criteria (88%). The modification of Ranson's criteria for biliary etiology didn't improve the sensitivity (56%) to detect severe cases of acute pancreatitis.


CONCLUSIONS
The Apache II system was the best for the early detection of severe acute pancreatitis. Its diagnostic sensitivity was higher than the multiple laboratory criteria analyzed.
Paredes Cotoré
J P
JP
Servicio de Cirugía General, Hospital General de Galicia, Facultad de Medicina, Universidad de Santiago de Compostela.
Bustamante Montalvo
M
M
Fernández Rodríguez
E
E
Valeiras Domínguez
E
E
Potel Lesquereux
J
J
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
Pronóstico de la pancreatitis aguda: Ranson o Apache II?