Acute pancreatitis occurs more frequently in HIV-infected patients, than in the general population.
In this study, researchers from Canada evaluated the frequency of severe acute pancreatitis in HIV-positive patients. They also assessed the accuracy of the Acute Physiology and Chronic Health Evaluation (APACHE II), Ranson, and Glasgow scales for predicting clinical disease severity.
The team retrospectively identified 73 HIV-infected patients with acute pancreatitis.
They established demographic and clinical parameters, as well as clinical outcomes.
The research team compared the sensitivities and specificities of the APACHE II, Ranson and Glasgow scales.
|APACHE II criteria predicted outcome with an overall accuracy of 75%.|
Of the 73 patients, 84% had AIDS.
The team found that the majority of pancreatitis cases were medication-induced (46%) or idiopathic (26%).
They observed that incidence appeared to be declining in the late 1990s.
The researchers determined that 15% of patients had a severe course. This was defined by death, admission to the intensive care unit, or local complications requiring surgery.
However, 25% were considered severe, using the criteria established at the International Symposium on Acute Pancreatitis in Atlanta in 1992.
The team found that the APACHE II criteria best predicted outcome with an overall accuracy of 75%, compared with 69% for Glasgow, and 48% for Ranson.
They established that maximal accuracy was achieved with cut-offs of 14 for APACHE II and 4 for the Glasgow and Ranson criteria.
Dr Gan's team concluded, "HIV-infected patients have a clinical outcome similar to that of the general population".
"Clinical predictive scales are applicable and useful in this population".