Outcome Analysis of APACHE-II Scoring System in Predicting 30 Days Mortality in Acute Pancreatitis in Tertiary Care Hospital

Muhammad Ajmal  Leghari; Waseem Ahmed Khan; Imran  Ashraf; Abdul  Hameed; Ahmad  Tariq; Muhammad Bilal Sikandar  Nagra

doi:10.51253/pafmj.v75i1.11619

Authors

Muhammad Ajmal Leghari Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Waseem Ahmed Khan Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Imran Ashraf Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Abdul Hameed Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Ahmad Tariq Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Bilal Sikandar Nagra Department of General Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i1.11619

Keywords:

APACHE score, Acute mortality, Necrosis, Organ failure, Pancreatitis, Prognosis

Abstract

Objective: To evaluate outcome analysis of Apache-II scoring system in predicting 30 days mortality in acute pancreatitis in tertiary care hospital.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Combined Military Hospital Rawalpindi, Pakistan from August 2023 and December 2023.

Methodology: One hundred patients with acute pancreatitis were examined retrospectively. Individuals who met the Ranson criteria or were hospitalized for>2 months were chosen. Mortality, organ failure, and pancreatic necrosis were the primary outcome measures. On the other hand, the occurrence of organ failure was analyzed with a score of Apache II at admission to the hospital.

Results: The 48-hour score was significantly correlated with organ failure (p=0.001), pancreatic necrosis (p<0.01), and mortality (p<0.01). In contrast, organ failure was the only factor with which the score at admission had a significant relationship (p=.007). A fatal outcome had a considerable connection (p=.03) with declining scores over 48 hours. The overall score of Apache II was substantially higher in non-survivors (p<.001) and was highly correlated with organ failure (p<.001) and pancreatic necrosis (p=.001). In contrast to 74% based on the admission score, 92% of patients had their outcomes correctly predicted by the 48-hour and combined scores.

Conclusion: The 48-hour score has a better prognostic value than the admission score in predicting which individuals with severe acute pancreatitis will have a poor prognosis. A declining APACHE II score 48 hours after admission identifies individuals who are at risk for negative results.

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