mGlasgow prognostic grading system versus mCTSI scoring system in predicting the prognosis of Acute Pancreatitis

Abstract

Abstract Acute Pancreatitis (AP) is a severe inflammation of the pancreas presenting with sudden onset of severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. The overall mortality rate is 3% to 10%, but patients with severe form of the disease are at an increased risk of death, with a mortality rate upto 28%. A large number of scoring systems are available to assess the severity of Acute Pancreatitis and predict the prognosis, but none can be considered ideal. The aim of the present study was to investigate, how accurate CT based indices are in predicting the severity and mortality of acute pancreatitis in comparison with the clinical Glasgow scoring system. AIMS AND OBJECTIVES – To compare mGlasgow (Imrie) scoring system with mCTSI scoring system in predicting the outcome of patients with Acute Pancreatitis MATERIAL AND METHODS – 53 patients, 26 (49.1%) males and 27 (50.9)% females who were admitted with the clinical diagnosis of Acute Pancreatitis were included in the study. All the patients were evaluated by mGlasgow (Imrie) scoring system. Patients with scores ≤ 2 were considered mild and with scores ≥3 were considered severe disease. They were subjected to CT scan after 72 hours and CTSI score ≤6 was considered mild and ≥ 7 was considered severe pancreatitis. RESULTS – 37 patients (69.8%) showed good results without any complications, 12 (22.6%) had complications and 4 (7.5%) patients expired. 3 expired due to septic shock, MODS and pulmonary complications. There was infected pancreatic necrosis with septic shock in the 4th patient. Glasgow score was ≥3 in 03 patients and ≤ 2 in 01 patient. CTSI score was ≥ 7 in 02 patients and ≤6 in 02 patients. CONCLUSION – There was no significant difference between mGlasgow score and mCTSI score in predicting the prognosis. mGlasgow scoring system is easily available and can be assessed at the bed side, hence can be used in predicting mortality and severity of the disease on admission to the hospital. mCTSI is good in predicting pancreatic necrosis and pancreatic & peripancreatic inflammation. CECT is not advisable in patients with deranged renal function, pregnant women and young children: mGlasgow scoring system can be used to assess the prognosis in these cases.