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Simplified criteria for predicting the severity of gallstone pancreatitis
Singh Kuldip, Nain PS, Matta H, Ohri A, Chaudhry A, Jain M
Abstract
BACKGROUND: There was a need for a simple method of predicting the severity of gallstone pancreatitis soon after admission, to guide the clinician for intensive monitoring, or for transfer to a specialist center. AIM: To validate the role of simplified criteria [white blood cell count (WBC) ≥ 14.5 x 103/dl; blood urea nitrogen (BUN) ≥ 12 mg/dl; random blood sugar (RBS) ≥ 150 mg/dl; pulse ≥ 100/min] in predicting the severity of gallstone pancreatitis at admission. SETTING AND DESIGN: This prospective study was performed on 54 patients with gallstone pancreatitis admitted in the Department of Surgery of a tertiary hospital. MATERIAL AND METHODS: Fifty-four patients with gallstone pancreatitis were followed for development of complications. Sensitivity analysis of Biliary Ranson ≥ 3, modified Imrie ≥ 3, acute physiology and chronic health evaluation II (APACHE-II) score of ≥ 5, WBC ≥ 14.5 x 103/dl, BUN ≥ 12 mg/dl, RBS ≥ 150 mg/dl, pulse ≥ 100/min and combinations of the four simplified criteria were compared using the Z -test. P < 0.05 was considered statistically significant. RESULTS: Both Biliary Ranson ≥ 3 and modified Imrie ≥ 3 had sensitivity of 96.15% and specificity of 96.43%. Both APACHE-II ≥ 5 and RBS ≥ 150 mg/dl had sensitivity of 88.46%, which is comparable to Biliary Ranson ≥ 3 and modified Imrie ≥ 3. CONCLUSION: RBS > 150 mg/dl can be used as a simplified prognostic indicator at admission in patients with gall stone pancreatitis and is comparable to Biliary Ranson ≥ 3, modified Imrie ≥ 3, and APACHE-II of ≥ 5.
Keywords
Gallstone pancreatitis, prognosis, random blood sugar
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