Predictive accuracy of clinical, laboratory, and radiological scores for severe acute pancreatitis

Acute pancreatitis (AP) is a serious and common medical emergency with major effects on morbidity and mortality. We tried to assess different scores in early prediction of severe AP. The current study was conducted between October 2018 and October 2022 to enroll all patients with acute AP. A total of 300 patients with AP were enrolled in the study. All patients were subjected to thorough history taking and clinical evaluation. The following scores were calculated; modified Ranson criteria (mRC) score at admission, mRC score at 48 h after admission, Acute Physiology and Chronic Health Examination-II score that consists of the following parameters (APACHE-II), Bedside Index of Severity in Acute Pancreatitis (BISAP) Score, Harmless Acute Pancreatitis (HAP) score, Computed tomography severity index (CTSI), neutrophil/lymphocytes ratio (NLR) and platelets/lymphocytes ratio (PLR). Mean age of enrolled patients was 49.50 years with range between 24 and 71 years old. Majority (66.7%) of patients was males. A total of 100 (33.3%) patients had severe AP (SAP). Predictors of SAP were NLR, PLR, mRC (after 48 h), HAP score, BISAP score and severe CTSI. CTSI and BISAP score have the best diagnostic accuracy (100% and 96.4%, respectively) followed by NLR (79%), PLR (65.9%) and mRC after 48 h (62.2%). AP still has mild course in majority of cases but SAP has serious outcome. Early recognition of patients who vulnerable to SAP may improve their outcome. BISAP and CTSI are better scores for prediction of SAP. Multi-centers studies are warranted with longer duration of follow up. Also, more studies are required to standardize CT timing.