Is APACHE II Score a Reliable Indicator in Necrotising Pancreatitis?

INTRODUCTION There has been an increasing amount of work worldwide in search for tests not only to be able to absolutely diagnose acute pancreatitis but more importantly to prognosticate patients at admission. The early prediction of the severity of an acute attack has important implications for management and timely intervention The APACHE II score is highly recommended worldwide for the assessment of severe pancreatitis (interstitial and necrotizing) AIM To evaluate whether APACHE II score a reliable indicator in necrotising pancreatitis as shown by contrast-enhanced computed tomography (CT). METHODOLOGY This is a retrospective study on 80 patients admitted with acute pancreatitis. All these patients underwent contrast enhanced CT within 72 hours of admission. RESULTS Of the 80 patients, 69 (86 %) had interstitial pancreatitis and 11 (14 %) had necrotizing pancreatitis. In 21 (30 %) of the 69 patients with interstitial pancreatitis, the APACHE II score was at least eight points, indicating severe pancreatitis (overestimation of the disease), whereas the score was less than eight in 7 (64 %) of 11 patients with necrotizing pancreatitis (underestimation). CONCLUSION The APACHE II score on admission to the hospital is unreliable to diagnose necrotizing pancreatitis.