Comparison of the effectiveness of different scoring systems and biochemical markers in determining the severity and complications of acute pancreatitis.

Background and study aim: The aim of the study is to demonstrate the effectiveness of different scoring systems and inflammatory markers in predicting the severity, local complications, pancreatic necrosis, and mortality of acute pancreatitis (AP).

Materials and methods: The data of 357 patients whom the severity of pancreatitis was classified according to the Revised Atlanta Classification System diagnosed with AP were retrospectively examined. Also The APACHE II, BISAP, mCTSI, and Ranson scores of all patients were calculated. After determining the cut-off values for scoring systems and inflammatory markers with ROC analysis, comparison for AP severity, local complication, necrosis, and mortality.

Results: In the study, 2.8% of patients had severe pancreatitis. It was found that the risk of developing local complications increased 2.82 times in cases with an 48^th-h CRP value >192 mg/L compared to those below this threshold, and 48.96 times in cases with an mCTSI score >2 compared to ≤ 2 cases. It was found that having a Ranson score >4 increased the risk of mortality by 9.07 times compared to having a score of ≤4 (p = 0.038). It was observed that having a BISAP >2 increased the risk of severe AP by 11.79 times compared to ≤2. In cases where the 48^th-h NLR value was >13.33, the risk of severe AP was found to have increased by 5.85 times.

Conclusion: Although the superiority of scoring systems could not be demonstrated in our study, CRP and MCTSI for local complications, BISAP for severity and Ranson score for mortality were the determining variables.