title: Accuracy and Predictability of PANC-3 Scoring System over APACHE II in Acute Pancreatitis: A Prospective Study.
abstract: BACKGROUND
  Acute Pancreatitis (AP) is one of the common conditions encountered in the emergency room. The course of the disease ranges from mild form to severe acute form. Most of these episodes are mild and spontaneously subsiding within 3 to 5 days. In contrast, Severe Acute Pancreatitis (SAP) occurring in around 15-20% of all cases, mortality can range between 10 to 85% across various centres and countries. In such a situation we need an indicator which can predict the outcome of an attack, as severe or mild, as early as possible and such an indicator should be sensitive and specific enough to trust upon. PANC-3 scoring is such a scoring system in predicting the outcome of an attack of AP.
  
  
  OBJECTIVE
  To assess the accuracy and predictability of PANC-3 scoring system over APACHE II in predicting severity in an attack of AP.
  
  
  METHODS
  This prospective study was conducted on 82 patients admitted with the diagnosis of pancreatitis. Investigations to evaluate PANC-3 and APACHE II were done on all the patients and the PANC-3 and APACHE II score was calculated.
  
  
  RESULTS
  PANC-3 score has a sensitivity of 82.6% and specificity of 77.9%, the test had a Positive Predictive Value (PPV) of 0.59 and Negative Predictive Value (NPV) of 0.92. Sensitivity of APACHE II in predicting SAP was 91.3% and specificity was 96.6% with PPV of 0.91, NPV was 0.96.
  
  
  CONCLUSIONS
  Our study shows that PANC-3 can be used to predict the severity of pancreatitis as efficiently as APACHE II. The interpretation of PANC-3 does not need expertise and can be applied at the time of admission which is an advantage when compared to classical scoring systems.
authors.affiliation: Junior Resident, Department of General Surgery, ESIC Medical College , Bangaluru, Karnataka, India .
authors.forename: Surag Kajoor
authors.initials: SK
authors.lastname: Rathnakar
authors.affiliation: Senior Resident, Department of General Surgery, ESIC Medical College , Bangaluru, Karnataka, India .
authors.forename: Vikram Hubbanageri
authors.initials: VH
authors.lastname: Vishnu
authors.affiliation: Professor, Department of General Surgery, ESIC Medical College , Bangaluru, Karnataka, India .
authors.forename: Shridhar
authors.initials: S
authors.lastname: Muniyappa
authors.affiliation: Junior Resident, Department of General Surgery, ESIC Medical College , Bangaluru, Karnataka, India .
authors.forename: Arun
authors.initials: A
authors.lastname: Prasath
keywords: Arterial blood gas analysis; Necrosis; Pleural effusion