A brief evaluation for pre-estimating the severity of gallstone pancreatitis.

CONTEXT An uncomplicated and easy-to-use method of pre-estimating the severity of gallstone pancreatitis shortly after admission was required in order to direct clinicians for monitoring and/or transferring to a specialized center. OBJECTIVE To determine the role of brief assessment in pre-estimating the severity of gallstone pancreatitis at admission. PATIENTS Fifty-eight patients with gallstone pancreatitis were consecutively followed regarding the course of complications. MAIN OUTCOME VARIABLES Sensitivity analysis of the Biliary Ranson score (>3), the modified Imrie score (>3), the acute physiology and chronic health evaluation II (APACHE-II) score (>5), white blood cell count (>14.5 x10(3)/dL), blood urea nitrogen (>12 mg/dL), random blood sugar (>150 mg/dL), pulse rate (>100 beats/min) and combinations of the four brief assessments were compared using the z-test. Two-tailed P values less than 0.05 were considered statistically significant. RESULTS Both the Biliary Ranson score >3 and the modified Imrie score >3 had a sensitivity of 96.4% and a specificity of 96.7%. Both the APACHE-II score >5 and random blood sugar >150 mg/dL had a sensitivity of 89.3% which is comparable to a Biliary Ranson score >3 and a modified Imrie score >3. CONCLUSION As compared to a Biliary Ranson score >3, a modified Imrie score >3 and an APACHE-II score >5, random blood sugar >150 mg/dL can be considered as an oversimplified and effective prognostic indicator at admission in patients with gallstone pancreatitis.