Abstract
Introduction: Acute pancreatitis (AP) is an acute inflammatory disease that can have various clinical courses. While majority of the cases heal without sequels, 10-20% of these can have severe course, and out of them 30% can be fatal. Early prediction of severity is clinically important since outcome of mild acute pancreatitis (MAP) is better than that of severe acute pancreatitis (SAP).
Several prognostic scoring systems and inflammatory markers have been studied with the purpose of determining the severity of acute pancreatitis. In this context the most frequently used scoring systems and inflammatory markers included RANSON's Score, BISAP Score, S.C-Reactive Protein (S.CRP) and Mean Platelet Volume (MPV).
Aims and Objectives: Comparative evaluation of MPV, S.CRP, RANSON'S Score and BISAP Score in prediction of severity of acute pancreatitis.
Methods: This prospective observational study was done during the period of June 2017 to November 2018 in JLN Medical College and Associated Hospital, Ajmer. The study included 100 patients of acute pancreatitis irrespective of age, sex, ethnicity or etiology.
Result: all 4 markers (MPV, S.CRP, RANSON's score and BISAP's score) were highly significant to predict severity of acute pancreatitis. BISAP's score was best to predict severity (at cut off value of 4) in comparison to other 3 markers. S.CRP and RANSON's score were equally sensitive to predict severity but better than MPV. MPV and S.CRP were nearly equally specific to predict severity but their specificity were higher than that of RANSON's score. Positive Predictive Value of MPV was very high in comparison to S. CRP and RANSON's score to predict severity. Negative Predictive Value of S. CRP and RANSON's score were nearly equal to predict severity, and both have better Negative Predictive Value then MPV.
Conclusion: MPV, S.CRP, RANSON’s score and BISAP score, all four markers can be used to predict the severity of acute pancreatitis. BISAP score was found to be the best predictor of severity of acute pancreatitis among all four markers. BISAP score equal to or greater than 4 invariably indicates severe acute pancreatitis. Prognostic accuracy of RANSON’s score and S.CRP is better than MPV in terms of sensitivity but less sensitive and specific than BISAP. MPV is also a good prognostic marker in terms of its specificity and easy availability in prediction of severity of acute pancreatitis.
Keywords: acute pancreatitis, severity, MPV, S.CRP, RANSON's score and BISAP's score.
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Corresponding Author
Dr Rajmani
Address: C/O Narayan Prasad Mathur, 2/281 Housing Board Colony, PNB Marg, Panchsheel Nagar. Ajmer (Raj.) 305001, India
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DOI: https://dx.doi.org/10.18535/jmscr/v7i3.140
