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Simple Post-Admission Test Score Found Accurate Predictor of Outcome in Pancreatitis

A simple score to assess the severity of patient illness, the Ranson score, is just as good a predictor of outcome in severe acute pancreatitis as APACHE III (Acute Physiology and Chronic Health Evaluation, third edition), a sophisticated computer-based rival.

The Ranson score, used to assess patients admitted to intensive care units, was most accurate in predicting adverse outcomes when it was determined 48 hours after hospital admission, rather than at admission.

Intensive care surgeons from the New York Presbyterian Hospital, New York, United States, found that the number of positive Ranson scores was a "valid predictor of outcomes" in 76 patients admitted with severe pancreatitis to a surgical intensive care unit.

These outcomes included the need for operative debridement, an ICU stay longer than seven days and mortality.

The researchers found that the Ranson score was significantly higher in those that did not survive their spell in intensive care compared with those that did (5.6 versus 3.4). Apache III scores were also significantly different in the survivors and the non-survivors. Nonsurvivors on average stayed 76.5 days in ICU, three times the stay of the survivors (24.9 days).

The Ranson score variables that predicted mortality most accurately were values for blood urea nitrogen, calcium, base deficit and fluid sequestration.

In the trial, 21.1 percent of the patients, who were on average nearly 62 years of age, died. They stayed in the intensive care unit for an average 10.4 days.
Arch Surg 2002; 137: 730-736. "Severity Scoring for Prognostication in Patients With Severe Acute Pancreatitis : Comparative Analysis of the Ranson Score and the APACHE III Score"

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