Akademik Veri Yönetim Sistemi
Istanbul Tip Fakultesi Dergisi, cilt.86, sa.3, ss.198-203, 2023 (ESCI)
Objective: Ranson criteria, introduced in 1974, was the first clinical prediction rule for acute pancreatitis in which five admission parameters and six (or five) late components collected within 48 hours were used to reach a clinical decision. This 48-hour follow-up requirement was not convenient for use in the emergency department setting. This study was undertaken to assess whether five admission Ranson parameters may have use in differentiating edematous pancreatitis from necrotizing pancreatitis in the emergency department setting. Material and Method: Patient data for this retrospective cohort study was gathered from 205 patients treated for acute pancreatitis from January 2018 to December 2022 in a tertiary care center. The patient files were extracted from the archives for clinical data gathering. Laboratory admission data and radiology reports were extracted from the automated laboratory reporting system. Result: The 205 acute pancreatitis patients were mostly female and in their sixth decade. The etiology was mostly biliary pancreatitis (76%). Patient history revealed that 80% was the first attack. The radiologic imaging study review revealed the majority of the patients had edematous pancreatitis (87%). Higher scores in admission Ranson score (aRS) weakly predicted increasingly higher probability (2.6% for aRS 0 to 28.6% for aRS 4-5) for the presence of necrosis without reaching statistical significance (p=0.055). When components of the score were analyzed, age, LDH levels, and glucose had no discriminating value, WBC parameter positivity significantly increased the odds of necrotizing pancreatitis, whereas positive AST level significantly decreased the risk of necrotizing pancreatitis. Conclusion: In conclusion, aRS had little utility in predicting pancreatic necrosis.