APACHE II Score for Early Severity Assessment in Acute Pancreatitis: A Prospective Clinical Study

Dr. Nakade Vaishnavi Gangadhar, Dr. T. Shivakumar, Dr. Prabhakara G. N., Dr. Amruth Sagar K. R., Dr. Nagesh Shambhu

Abstract: Acute pancreatitis (AP) exhibits variable clinical severity ranging from mild, self - limiting illness to life - threatening complications. Early identification of severe cases is critical for appropriate management. The APACHE II (Acute Physiology and Chronic Health Evaluation II) scoring system, although developed for general ICU patients, is frequently applied in AP for early severity assessment. Objective: To evaluate the role of APACHE II in early risk stratification of acute pancreatitis and its correlation with clinical outcomes. Methods: A prospective observational study was conducted at Sri Siddhartha Medical College, Tumkur over 24 months, including 136 patients diagnosed with AP. APACHE II scores were calculated within 24 hours of admission. Data on demographics, etiology, clinical course, complications, and outcomes were recorded. Statistical analysis was performed to assess sensitivity, specificity, PPV, and NPV of APACHE II in predicting severe disease. Results: Among the 136 participants (mean age: 42.41 ? 12.26 years), 82% were male. Based on APACHE II, 40% of patients were classified as low risk (score <8), 44.7% as moderate risk (8?11), and 6% as high risk (>11). The sensitivity and specificity of APACHE II in predicting severe AP were 83.3% and 97.5% respectively, with an overall accuracy of 94.7%. Higher APACHE II scores correlated significantly with increased rates of organ failure, ICU admission, and mortality (p<0.05). Conclusion: The APACHE II scoring system is a reliable tool for early prediction of disease severity in acute pancreatitis. It facilitates timely intervention, guides ICU resource utilization, and improves prognostic accuracy in clinical practice.

Keywords: Acute pancreatitis, APACHE II, risk stratification, ICU admission, clinical outcome