Thursday April 13, 2006
Fan Score (Hong-Kong criteria or 20/200 Score)
Why we don't hear about the most easiest way to assess the severity of acute pancreatitis, with only 2 parameters:
1. Azotemia - BUN more than 20 mg/dL (7.4 mmol/L)
2. Glycemia - more than 200 mg/dL ( 11 mmol/L)
Reason this criteria failed to gain ground, is conflicting reports in literature. Originally, Fan and colleague reported the sensitivity of 76% and specificity of 75% but later 2 studies failed to confirm the high sensitivity (only 33% 4 and 52% 3 respectively). Study in reference # 3 also found that best prediction to severity of acute pancreatitis was provided by the APACHE II score 24 hours post admission with sensitivity of 79% and specificity of 82% . Famous Ranson criteria in same study showed sensitivity of 79% but specificity was only 56%
Related article: New Serum Markers for the Detection of Severe Acute Pancreatitis in Humans - Am. J. Respir. Crit. Care Med., Volume 164, Number 1, July 2001, 162-170
References: (click to get abstrat/article)
1. Assessment of severity of acute pancreatitis: a comparison between old and most recent modalities used to evaluate this perennial problem - World J Gastroenterol 1999; August 5(4):283-285
2. Fan ST, Choi TK, Lai ECS, Wong J. Prediction of severity of acute pancreatitis: an alternative approach. - Gut,1989;30:1591-1595
3. Failure of the Hong Kong criteria to predict the severity of acute pancreatitis - Int J Pancreatol. 1997 Dec;22(3):201-6.
4. The Hong Kong criteria and severity prediction in acute pancreatitis - Int J Pancreatol. 1994 Jun;15(3):179-85.