Published: 2020-08-27

Role of PANC-3 score to predict severe acute pancreatitis

Sunil Kumar Meena, Arvind Kumar Koslia, Anmol Thakur


Background: Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera. Prediction of severity is an essential step in the management of acute pancreatitis. 50% of mortality can be reduced to 8% by its early recognition. PANC-3 score is widely available test that can be performed quickly, easy to measure with high accuracy in predicting acute pancreatitis.

Methods: This cross-sectional study was conducted in the department of general surgery, VMMC and Safdarjung Hospital over 50 patients admitted with acute pancreatitis. After making the clinical diagnosis, PANC -3 score, modified ATLANTA score, APACHE II were done. CRP and CTSI (computed tomography sensitivity index) were calculated and correlated.

Results: Mean age was 44.74 years and most common cause was biliary tract pathology. Mortality observed in 5 patients, 11 patients had severe disease. Sensitivity of PANC- 3 was 81.82%, specificity -92.31% with 75% PPV and 94.7% NPV.

Conclusions: PANC-3 can be used to predict the severity of pancreatitis as efficiently as Modified ATLANTA classification/APACHE II. It uses only three criteria which are easily done, and available in the basic health care setup. Its interpretation does not need expertise and can be applied at the time of admission which is an advantage when compared to classical scoring systems. 



Full Text:



Cruz-Santamaría DM, Taxonera C, Giner M. Update on pathogenesis and clinical management of acute pancreatitis. World J Gastrointest Pathophysiol. 2012;15(3):60-70.

Skipworth JRA, Pereira SP. Acute pancreatitis. Curr Opin Crit Care. 2008;14:172-8.

Frey CF, Zhou H, Harvey DJ, White RH. The incidence and case-fatality rates of acute biliary, alcoholic, and idiopathic pancreatitis in California, 1994-2001. Pancreas. 2006;33:336-44.

Baker S. Diagnosis and management of acute pancreatitis. Critical Care and Resuscitation. 2004;6:17-27.

Whitcomb DC. Clinical practice. Acute pancreatitis. N Engl J Med. 2006;354(20):2142-50.

Beger HG, Isenmann R. Surgical management of necrotizing pancreatitis. Surg Clin North Am. 1999;79:783-800.

Werner J, Feuerbach S, Uhl W, Büchler MW. Management of acute pancreatitis:From surgery to interventional intensive care. Gut. 2005;54:426-36.

Mofidi R, Duff MD, Wigmore SJ, Madhavan KK, Garden OJ, Parks RW et al. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. Br J Surg. 2006;93:738-4.

Williams S, Simms HH. Prognostic usefulness of scoring systems in critically ill patients with Severe Acute Pancreatitis. Critical Care Med. 2000;28(8):3124-5.

Alphonso B, Toyia JS, Tara D, David. The panc 3 score: a rapid and accurate test for predicting severity on presentation in acute pancreatitis. J Clin Gastroenterology. 2007;41(9):855-8.

Uhl W. A randomized double blind, multi-centric trial of octreotide in moderate to severe acute pancreatitis. Gut. 1999;(45):97-104.

Marshall JB. Acute pancreatitis a review with emphasis on new development. Arch Int. Medicine. 1993;(153):1185-98.

Steinberg W, Tenner S. Acute pancreatitis. N Engl J Med. 1994;330:1198-210.

Brown A, Stevenson JT, Dyson T, Grunkenmeier D. The PANC 3 score: A rapid and accurate test for predicting severity on presentation in acute pancreatitis. J Clin Gastroenterol. 2007;41(9):855-8.

Brown A, Orav J, Banks PA. Hemoconcentration is an early marker for organ failure and necrotizing pancreatitis. Pancreas. 2000;20(4):367–72.

Panda C, Nayak NK, Behera MR, Nayak SK. PANC 3 score as a simple cost-effective scoring system in predicting severity of acute pancreatitis. Int Surg J. 2017;4(12):4066-70.

Beduschi MG, Mello ALP, Von-muhlen B, Franzon O. The PANC 3 score predicting severity of acute pancreatitis.ABCD Arq Bras Cir Dig. 2016;29(1):5-8.

RathnakarSK, Vishnu VH, Muniyappa S, Prasath A. Accuracy and Predictability of PANC-3 Scoring System over APACHE II in Acute Pancreatitis: A Prospective Study. J Clinical Diagnostic Res. 2017;11(2):PC10-3.

Uhl W, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG et al. IAP Guidelines for the Surgical Management of Acute Pancreatitis. Pancreatology. 2002;2:565-73.

Ocampo C, Silva W, Zandalanzini H. Pleureal Effusion is Superior to Multiple Factor Scoring System in predicting Acute Pancreatitis outcome. Acta Gastroenterol Latinoam(in Spanish). 2008;38(1):34-42.

Shah AS, Gupta AK, Ded KS. Assessment of PANC3 Score in Predicting Severity of Acute Pancreatitis. Niger J Surg. 2017;23(1):53-7.

Fukuda JK, Franzon O, Resende-Filho Fde O, Kruel NF, Ferri TA. Prognosis of acute pancreatitis by PANC 3 score. Arq Bras Cir Dig. 2013;26:133-5.

Vasudevan S, Goswami P, Sonika U, Thakur A, Sreenivas V, Saraya A. Comparison of Various Scoring Systems and Biochemical Markers in Predicting the Outcome in Acute Pancreatitis. Pancreas. 2018;47(1):67-71.