Comparative Assessment of PANC-3 and Acute Physiology and Chronic Health Evaluation II Scores in Acute Pancreatitis: A Prospective Study.

Abstract

Background: The global incidence of acute pancreatitis (AP) is increasing, and it has an unpredictable course. As AP is associated with high mortality rates, it is important to effectively assess severity and manage the disease.

Aims: We assessed the use of PANC-3 scores for predicting the severity of AP and compared these scores with the Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores.

Materials and methods: A prospective study in patients with AP at a tertiary care hospital in Karad, India. Demographic characteristics, clinical presentation, laboratory findings and radiological data of the patients were recorded within 24 h of admission. The severity of AP was assessed using PANC-3 and APACHE-II scores. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both the scoring systems were calculated and compared.

Results: A total of 80 patients with AP were included in the study. Most of the patients were in their early thirties (31-35 years), and alcohol consumption was the leading aetiological factor. The PANC-3 scores exhibited a strong predictive accuracy for severity of AP. There was excellent agreement between the PANC-3 and APACHE-II scores (κ =0.8855). Sensitivity (94.1% vs. 88.2%), PPV (94.1% vs. 93.8%) and NPV (98.4% vs. 96.9%) were higher in APACHE-II, but specificity was equivalent between both systems (both 98.4%).

Conclusions: Using PANC-3 scores, we were able to accurately predict the severity of AP in a tertiary care hospital setting. We observed that the performance in predicting the severity of AP was similar using the PANC-3 and APACHE-II scores.