Improved Prediction of Outcome in Patients With Severe Acute Pancreatitis by the APACHE II Score at 48 Hours After Hospital Admission Compared With the APACHE II Score at Admission

Results: A significant association was found between the 48-hour score and the presence of pancreatic necrosis (P .001), organ failure (P=.001), and death (P .001). By contrast, the APACHE II score at admission was significantly associated only with the presence of organ failure (P=.007). Deteriorating APACHE II scores over 48 hours were significantly associated with a fatal outcome (P=.03). The combined APACHE II score (defined as the sum of the admission and 48-hour scores) was significantly higher among nonsurvivors than survivors (P .001), and was strongly associated with the presence of pancreatic necrosis (P=.001) and organ failure (P .001). The 48-hour and combined scores accurately predicted outcome in 93% of the patients compared with 75% by the admission score.