Validation of Harmless Acute Pancreatitis Score for Non- Severe Acute Pancreatitis

Abstract

Background: In contrast to more complicated scoring systems requiring many parameters, Harmless Acute Pancreatitis Score (HAPS) which is very simple to calculate, has already been described in the literature as a predictor of non-severe acute pancreatitis. In this study, we aimed to validate this score in the form of sensitivity and specificity in predicting non severe course of acute pancreatitis.
Methods: This study was conducted over 1 year among patients admitted with acute pancreatitis in a tertiary care center of Nepal. The HAPS scores were calculated using the data obtained at admission and all patients were classified according to Revised Atlanta Classification 2012. Data were compared in terms of diagnostic parameters like (absence of abdominal guarding or rebound tenderness, creatinine < 2mg/dl or hematocrit of <43 for male and <39.6 for female) and sensitivity, specificity, positive and negative predictive value were determined.
Results: Out of 120 patients, 46 were female and 74 were male. HAPS were positive in 62 and negative in 58 patients. HAPS, a negative scoring system, correctly predicted the disease severity in 105 patients, with the specificity of 94.3% and sensitivity of 82.1%. Statistical analysis showed moderate agreement (Kappa = 0.751, p < 0.001), when compared with Revised Atlanta Classification.
Conclusions: HAPS score was effective in identification of patients who will run non-severe course of acute pancreatitis. Assessment can be completed within an hour from the presentation, making it an easy, rapid, cost effective and convenient screening tool. This helps in decision making for the management of non-severe pancreatitis (HAPS positive) at an optimal level of care and to refer/admit severe (HAPS negative) pancreatitis.
Keywords: Acute pancreatitis; HAPS score; Nepal; revised atlanta classification.