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BACKGROUND:The aim of this study was to examine the effect of systemic immunoinflammatory index (SII), calculated on presentation to the emergency department (ED), on the prediction of clinical outcomes of patients who were diagnosed with acute pancreatitis (AP). METHODS:This research was designed as a single-center, cross-sectional, and retrospective study. Adult patients who were diagnosed with AP in the ED between October 2021 and October 2022 in the tertiary care hospital, whose diagnostic and therapeutic procedures were complete in the data recording system, have been included in the study. RESULTS:Mean age, respiratory rate, and length of stay of the non-survivors were significantly higher than the mean of the survivors (t-test, p=0.042, p=0.001, and p=0.001, respectively). Mean SII score of the patients with fatal outcome was higher than the survivors (t-test, p=0.001). ROC analysis of the SII score to predict mortality revealed that the area under the curve was found to be 0.842 (95%CI 0.772-0.898), and the Youden index was 0.614, (p=0.001). When the cutoff value of the SII score in determining mortality is >1243, the sensitivity of the score was found to be 85.0%, specificity 76.4%, positive predictive value 37.0%, and negative predictive value 96.9%. CONCLUSION: SII score was statistically significant in estimating mortality. SII calculated on presentation to the ED can be a useful scoring system to predict the clinical outcomes of patients who were admitted to the ED and were diagnosed with AP.