Is the use of specific scoring system still justified in early evaluation of acute pancreatitis?

Study aim: Acute pancreatitis (AP) is a potentialy life-threatening disease in which specific severity scoring system has been developed. The aim of t his prospective study was to compare efficiency of the general severity of illness scoring system and the most widely used specific scoring system of AP in order to simplify the initial monitoring of AP at the time of admissi on. Patients and methods: Eighty-seven patients with AP were hospitalized in th e same center. There were 47 men and 40 women (mean age: 57 +/- 16 years). Specific scores (Ranson, Imrie, Blarney) and general severity of illness sc ores (SAPSI, SAPS II, Apache II) were calculated for each patient. Radiolog ical scores (Hill, Balthazar) were also calculated when TDM was early perfo rmed (80 %). Each scoring system was correlated with severity, morbidity an d mortality of AP and its predictive value evaluated by the area under the ROC curve. Results: Aetiology of AP was predominantly biliary (20 %) and alcoholic (70 %). Eight per cent of the patients died and 29 % of AP were classified as severe according to the Atlanta Congress Score. Morbidity rate was 40 %. Al l the scoring systems were significantly correlated with mortality and exhi bit ROC curve area between 0.77 and 0.84, resulting in a similar prediction of death. Conclusion: Specific scoring system and general severity of illness scoring system have the same predictive efficiency in acute pancreatitis. The use of the specificity scoring system seems to be no more justified in acute pa ncreatitis. (C) 2000 Editions scientifiques et medicales Elsevier SAS.