Prediction of Severity in Acute Pancreatitis

Admission laboratory data of 203 patients suffering from acute pancreatitis were analysed to search for a simpler method of prediction of severity than the traditional multifactor prognostic scoring system. By discriminant analysis, admission serum urea and plasma glucose were identified to be factors with independent significance in predicting severity. If the presence of either factor higher than the cutoff point (urea > 7.4 mmoi/l, glucose > 11.0 mmol/l) was considered as an indication of severe disease, then the sensitivity of this method was 75.0%, specificity 80.3% and the accuracy 79.3%. The predictive ability of this method was comparable with the Glasgow multifactor scoring system when the latter was also used to grade severity of our patients. It has the advantage, however, of simplicity and the ability of predicting severity at the time of admission. According to clinical and morphological criteria acute pancreatitis can be divided into two subgroups. On the one hand, it is a self-limiting disease, morphologically characterized by an interstitial edema within and outside the pancreatic gland, sometimes with additional peripancreatic fatty tissue necrosis and linked to a mortality rate of below 1%. On the other hand, there is the morphologically 61