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Validation of the modified R anson versus G lasgow score for pancreatitis in a S ingaporean population
Author(s) -
Tan Yong Hui Alvin,
Rafi Shumaila,
Tyebally Fang Mirriam,
Hwang Stephen,
Lim Ee Wen,
Ngu James,
Tan SuMing
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13139
Subject(s) - medicine , pancreatitis , acute pancreatitis , receiver operating characteristic , area under the curve , retrospective cohort study , population , gastroenterology , environmental health
Background The characteristics of patients with acute pancreatitis in multi‐ethnic S ingapore differ from that of the populations used in formulating the modified R anson and G lasgow scores. The use of these scoring systems has not previously been validated in the S ingaporean setting. This study aims to validate and compare the prognostic use of the modified R anson and G lasgow scores, and to determine the superiority of one score over the other in predicting the outcome for acute pancreatitis in the S ingaporean population. Methods This is a 3‐year retrospective study of patients diagnosed with acute pancreatitis at our centre. Patients with chronic pancreatitis, acute on chronic pancreatitis, iatrogenic pancreatitis, pancreatic cancer as well as those with incomplete R anson or G lasgow scores were excluded from the study. Case notes and computer records were reviewed for local complications of pancreatitis and organ failure. Receiver operator characteristic ( ROC ) curves of the R anson and G lasgow scores were plotted for the prediction of severity and mortality. Results Between J anuary 2010 and D ecember 2012, 230 cases were diagnosed with acute pancreatitis. A majority of the patients had mild pancreatitis ( n = 194, 84.3%), and the overall 30‐day mortality rate was 3.5% ( n = 8). ROC of the R anson and G lasgow scoring systems for mortality showed an area under curve ( AUC ) of 0.854 ( P = 0.001) and 0.776 ( P = 0.008), respectively. For severity, the AUC for the modified R anson and G lasgow score was calculated to be 0.694 and 0.668, respectively. Conclusions The ROC curves of R anson and G lasgow scores for mortality are comparable with that published in earlier studies. In a Singaporean population, the R anson score is more accurate in the prediction of mortality. However, both scoring systems are poor predictors for severity of acute pancreatitis.