Ranson and Imrie used clinical and laboratory criteria to provide early classifications of pancreatic damage ( Tabled). The high proportion of alcoholic patients in the original studies produced misleading results with regard to those with a gallstone etiology. This shortcoming led to slight modifications to extend accuracy; however, the poor specificity of Ranson scoring and the limited sensitivity of the Imrie system impair their practical value for early assessment of acute pancreatitis. In addition, laboratory data collection is often incomplete or takes 48 h to obtain, thereby introducing potential errors or delaying effective management of ongoing complications. As these systems only include early data, they may be valuable in identifying those who will benefit most from early intensive care. However, acute pancreatitis is a dynamic process; although these systems correlate with the extent of necrosis and with the likelihood of abscess and death, they do not enable accurate prediction of late septic complications on an individual basis.
Table 4 Multiple prognostic factors in acute pancreatitis: variables, time of collection, advantages, and definition of severe acute pancreatitis
Other scores for quantifying severity of acute illness have proved more accurate in identifying severe attacks and in predicting pancreatic necrosis and regional infection. On admission, an APACHE II score of at best 13 correctly predicted outcome in 77 per cent of attacks and identified 63 per cent of severe attacks. After 48 h, outcome was correctly predicted in 88 per cent of attacks, compared with 69 per cent and 84 per cent for the Ranson and Imrie scores respectively. Sequential scoring may be most useful for monitoring pancreatic necrosis.
Was this article helpful?
One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.