Role of PANC-3 score to predict severe acute pancreatitis

Abstract

Background: Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera. Prediction of severity is an essential step in the management of acute pancreatitis. 50% of mortality can be reduced to 8% by its early recognition. PANC-3 score is widely available test that can be performed quickly, easy to measure with high accuracy in predicting acute pancreatitis.Methods: This cross-sectional study was conducted in the department of general surgery, VMMC and Safdarjung Hospital over 50 patients admitted with acute pancreatitis. After making the clinical diagnosis, PANC -3 score, modified ATLANTA score, APACHE II were done. CRP and CTSI (computed tomography sensitivity index) were calculated and correlated.Results: Mean age was 44.74 years and most common cause was biliary tract pathology. Mortality observed in 5 patients, 11 patients had severe disease. Sensitivity of PANC- 3 was 81.82%, specificity -92.31% with 75% PPV and 94.7% NPV.Conclusions: PANC-3 can be used to predict the severity of pancreatitis as efficiently as Modified ATLANTA classification/APACHE II. It uses only three criteria which are easily done, and available in the basic health care setup. Its interpretation does not need expertise and can be applied at the time of admission which is an advantage when compared to classical scoring systems.

PANC-3 Score in Predicting the Severity of Acute Pancreatitis

“…[3,4] 50% mortality associated with severe acute pancreatitis can be reduced to 8% by early recognition. [5,6] Prognostic scoring systems such as Ranson's are not practical to assess probable disease course because it takes 48 hours to get the data needed to gauge prognosis. Our data con rm that the Panc 3 score is able to accurately predict the likelihood that an individual will develop SAP.…”

“…Severe acute pancreatitis de ned as persistent organ failure (> 48 h). 5 The PANC3 parameters were measured, and it was seen if the patients with all the three parameters positive had severe acute pancreatitis or not.…”

“…The diagnosis of Acute pancreatitis(AP) requires at least the presence of two of the three following criteria: Abdominal pain consistent with the disease Biochemical evidence of pancreatitis (serum amylase and/or lipase greater than three times the upper limit of normal) and Characteristic ndings from abdominal imaging. [5] In 2012, two new classi cations systems of AP were published: Determinant-Based Classi cation of Acute Pancreatitis Severity (DBC) and the Revised Atlanta Classi cation 2012 (RAC). The novel DBC was based on a global web-based survey and a dedicated international symposium with contributors from different disciplines: Email invitations were delivered to 528 pancreatologists from 55 countries, and 240 pancreatologists from 49 countries participated in the survey.…”