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Validation of APACHE IV in patients with severe acute pancreatitis


Scoring systems represent classification systems or point systems that have been designed for making quantitative statements regarding the severity of a disease, its prognosis, and its course. These systems are based on physiologic abnormalities and have been successful in measuring severity of illness among critically ill patients. Furthermore, scores may serve the purposes of assessing therapies, of quality control and of quality assurance, and of an economic evaluation of intensive care. We validated the APACHE IV benchmark for a subset of patients with severe acute pancreatitis (SAP).


Twenty consecutive patients of SAP (as per Balthazar's CT classification of SAP) admitted to a surgical ICU between February 2007 and December 2007 were enrolled in the study. The length of stay and mortality percentages was predicted using APACHE IV and later both the variables were compared with the observed data.


Predictive ICU length of stay was 4.69 days (2.6–6.04) whereas the exact ICU length of stay of patients was 25 (9.5–103) days. Observed mortality was 20% (four patients) in our study, as compared with 0% predicted mortality.


APACHE IV could not be validated in our subset of patients of SAP. The predictive ICU length of stay and mortality percentage did not correlate with our experience in such patients.


  1. Zimmerman JE, et al.: Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med 2006, 34: 1297-1310. 10.1097/01.CCM.0000215112.84523.F0

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Kakar, P., Govil, D., Gupta, S. et al. Validation of APACHE IV in patients with severe acute pancreatitis. Crit Care 12 (Suppl 2), P500 (2008).

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