A comparative study on APACHE-II,Balthazar score and Extrapancreatic inflammation on abdominal computed tomography system in predicting the outcome of patients with acute pancreatitis.

Objective To assess the value of three clinical diagnostic criteria systems,the APACHE-Ⅱ,Balthazar score and Extrapancreatic inflammation on Abdominal Computed tomography(EPIC) in predicting outcome of patients with acute pancreatitis.Methods One hundred and seventy-eight patients with acute pancreatitis who underwent an abdominal CT scan within 24 h after admission were studied prospectively in the study.To assess the value of predicting severe AP and complications,the APACHE-Ⅱ score,the Balthazar score,EPIC score were calculated and evaluated by calculating receiver operator characteristic(ROC)curves,the sensitivity,the specificity,the Youden Index and the area under the ROC curve.Results 46 of 178 patients developed severe disease.The mean score of the three criteria system was significantly higher in the group of severe AP than the mild AP one(P0.05).An EPIC score of 4.5 or more had a 0.870 sensitivity,0.884 specificity and a 0.929 AUROC for predicting severe pancreatitis.EPIC score also has the largest AUROC to predict local and systemic complications.Conclusion In patients with AP,EPIC allows accurate estimation of disease severity and complication mobidity within 24 h of admission.