Evaluation of four scoring systems in prognostication of acute pancreatitis for elderly patients

Abstract

Background To evaluate the ability of four scoring systems (Ranson, BISAP, Glasgow, and APACHE II) to predict outcomes of acute pancreatitis (AP) in elderly patients. Methods This was a retrospective study of 918 patients presenting with AP at Zhongda Hospital Southeast University, from January 2015 to December 2018. We divided patients into two groups: 368 patients who were ≥ 60 years old, and 550 patients who were < 60 years old. Four scoring systems were used to analyze all patients. Results The severity of the disease, and mortality were significantly different between the two groups (p < 0.05), while the difference between the two groups about pancreatic necrosis is statistically insignificant (p = 0.399). The differences of the AUCs (Area under curves) for prediction of outcome of SAP (severe acute pancreatitis) between the two groups were statistically significant for Ranson and APACHE II (p < 0.05), but not for the differences between BISAP and Glasgow. All the four scoring systems were similar in terms of prediction of pancreatic necrosis and death in both groups. Conclusions Prediction of severity, pancreatic necrosis, and death in AP for elderly patients can be performed very well by using BISAP. APACHE II is more suitable for younger patients when dealing with severity. Ranson and Glasgow can be used to evaluate all AP patients in most cases; however, Ranson is more effective for younger patients when used to assess severity.

Comparision of the scoring systems to predict clinical outcomes in older adults with biliary pancreatitis: a cross-sectional study

“…The BISAP is a more recent scoring system aimed at early detection of patients at risk for in-hospital mortality (11,18), and recent prospective clinical studies have shown it to be reliable in the evaluation of patients with AP (11). A recent study by Li et al (30) revealed that the BISAP score is valid for predicting disease severity, pancreatic necrosis, and mortality in older adults patients, whereas the APACHE II score is more suitable for younger patients. In our study, we compared the BISAP, Glasgow, and APACHE II scores and found that BISAP and APACHE II were significantly different only in the prediction of complications, and the 3 scoring systems were not significantly superior to one another in terms of the remaining parameters.…”

Diagnosis, severity stratification and management of adult acute pancreatitis–current evidence and controversies

“…However, there is a different extent of impact of age across various scoring systems. Li et al [ 44 ] analyzed Ranson’s score, APACHE-II and BISAP scores in elderly patients[ 44 ]. They compared the traditional cut-off with an additional point added for elderly patients: ≥ 4 compared to ≥ 3 for Ranson’s score, ≥ 9 for compared to ≥ 8 for APACHE-II score and ≥ 3 compared to ≥ 2 for BISAP score.…”

Перфузійна Дисфункція При Гострому Панкреатиті: Перспективні Напрямки Удосконалення Діагностики Та Стратифікації Захворювання

“…Близько 80% випадків ГП мають легкий перебіг та проходять самостійно, без наслідків. У решті випадків хвороба прогресує, некроз в підшлунковій залозі розповсюджується та виникає перипанкреатит [4]. Незважаючи на те, що летальність, пов'язана з ГП, поступово знижується та зага-льна смертність від цього захворювання становить 2-8% [5], при наявності тяжкого ГП, смертність залишається на надзвичайно високому рівні та може сягати 60% [3].…”