Severe acute pancreatitis admitted to intensive care unit: SOFA is superior to Ranson’s criteria and APACHE II in determining prognosis

Abstract

Severe acute pancreatitis usually requires intensive management of cardiovascular, pulmonary, renal, and septic complications. Many scoring systems are used in determining the outcomes. The aim of the study was to evaluate the role of three scoring systems, i.e. Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and modified Ranson's criteria, in predicting mortality rate in patients with severe acute pancreatitis as well as other factors influencingmortality in patients admitted to intensive care unit. Charts of 43 patients hospitalized in intensive care unit with severe acute pancreatitis were screened retrospectively. Four patients were excluded. Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment and modified Ranson's scores were calculated on admission, and Sequential Organ Failure Assessment score was recorded on weekly intervals during the intensive care unit stay. Thirty-nine patients were included in the study (65% male, mean age: 61 years). The intensive care unit mortality was 64% and hospital mortality was 71%. Sequential Organ Failure Assessment scores correlated significantly with mortality. All patients with Sequential Organ Failure Assessment score ≥11 at any time during intensive care unit stay had higher mortality (80% sensitivity, 79% specificity, ROC=0,837). Although Acute Physiology and Chronic Health Evaluation II is used to estimate mortality prognosis, we could not find any statistically significant association between Acute Physiology and Chronic Health Evaluation II scores and mortality. Various scoring systems are used to determine the prognosis of severe acute pancreatitis. In this group of patients, higher Sequential Organ Failure Assessment scores predict higher intensive care unit/hospital mortality.