Cristina Galache, Jorge Santos-Juanes and Luis Rodrigo.
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Javaid Iqbal Gulshan, Saurabh Raina and Sanjay Kumar Bhasin
Background: Acute pancreatitis poses challenges due to its highly variable clinical course, making it difficult to predict and plan treatment protocols despite advancements in medicine. Consequently, treatment outcomes have seen little improvement. Given the unpredictable nature of pancreatitis, numerous scoring systems have emerged to aid in its early severity prediction. HAPS stands out as one such system, designed for early prognosis and to rule out severe pancreatitis, while Ranson\\\\\\\'s scoring system assesses severity based on admission investigations and those conducted after 48 hours.
Methods: This was a Prospective observational study that was conducted on patients with acute pancreatitis admitted to the Postgraduate Department of Surgery GMC Jammu from 1st November 2019 to 31st October 2020.
Results: The study population predominantly consisted of females (66.4%) with a mean age of 47.44 years and a range spanning from 19 to 85 years. The most prevalent symptom was abdominal pain, observed in all patients (100%), followed by nausea and vomiting in 81.8% and 77.3% respectively. Ranson\\\\\\\'s scoring system demonstrated a sensitivity of 87.5%, specificity of 83.3%, and an accuracy of 92%. Meanwhile, HAPS showed a sensitivity of 93%, specificity of 87.5%, and an accuracy of 97%. Within the initial 24 hours, among 8 patients diagnosed with severe pancreatitis, Ranson\\\\\\\'s scoring incorrectly classified 3 patients as mild and correctly identified 5 patients as severe, whereas HAPS accurately predicted severe pancreatitis in 7 out of 8 patients. Upon admission, abdominal ultrasound revealed a bulky pancreas in 6 out of 8 patients diagnosed with severe pancreatitis, while 2 cases showed a normal pancreas size.
Conclusion: Acute pancreatitis presents challenges in predicting its course and planning treatment due to its unpredictable nature. Despite medical advancements, outcomes remain unchanged. Various scoring systems, including HAPS, aim to predict severity early on admission. HAPS effectively identifies patients with mild pancreatitis upon admission, based on readily available parameters for assessment. Comparing with Ranson’s score, HAPS accurately identifies those with a mild course. Based on our study and literature reviews, HAPS emerges as a valuable tool for predicting pancreatitis severity upon admission, particularly in resource-limited settings.
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