Güzel Yunus Emre, Çolak Nese, Okuv Ahmet Can, Teymuroğlu Sefer, Teke Muhammet İkbal
Department of Emergency Medicine, School of Medicine, Dokuz Eylul University, Izmir, Türkiye.
Department of Emergency Medicine, Adiyaman Education and Research Hospital, Adiyaman, Türkiye.
Turk J Emerg Med. 2024 Jul 1;24(3):165-171. doi: 10.4103/tjem.tjem_14_24. eCollection 2024 Jul-Sep.
Several scoring systems are used to predict prognosis in acute pancreatitis (AP), but their predictive success varies. This study compares the validity of the commonly used Bedside Index of Severity in AP (BISAP) score with the newly developed WL score and the Chinese Simple Scoring System (CSSS) score in predicting mortality and unfavorable prognostic outcomes in AP patients.
This retrospective descriptive study included all AP patients presenting to the emergency department from June 2, 2019, to June 2, 2022. Patient demographics, vital signs, laboratory values, and imaging findings were recorded, and WL, CSSS, and BISAP scores were calculated. The effectiveness of these scores in predicting adverse outcomes and mortality was compared.
Among 357 patients, 53.2% were male, with a median age of 62 years (interquartile range: 48-75). Area under the curve (AUC) values for 7-day outcomes were 0.956 for WL, 0.759 for CSSS, and 0.871 for BISAP; for 30-day outcomes, AUC values were 0.941 for WL, 0.823 for CSSS, and 0.901 for BISAP; and for poor prognostic outcomes, AUC values were 0.792 for WL, 0.769 for CSSS, and 0.731 for BISAP.
In AP patients, WL, CSSS, and BISAP scores are effective predictors of unfavorable prognosis and mortality. WL score outperforms the CSSS and BISAP scores in predicting 7-day and 30-day mortality and poor prognosis. After WL, BISAP is the second-best system for predicting mortality. For predicting unfavorable prognoses, CSSS is the second-best system after WL. The simplicity of calculating the WL score based on four laboratory parameters makes it a preferable choice.
多种评分系统用于预测急性胰腺炎（AP）的预后，但其预测成功率各不相同。本研究比较常用的AP床边严重程度指数（BISAP）评分与新开发的WL评分及中国简易评分系统（CSSS）评分在预测AP患者死亡率和不良预后结局方面的有效性。
这项回顾性描述性研究纳入了2019年6月2日至2022年6月2日期间到急诊科就诊的所有AP患者。记录患者的人口统计学资料、生命体征、实验室检查值和影像学检查结果，并计算WL、CSSS和BISAP评分。比较这些评分在预测不良结局和死亡率方面的有效性。
357例患者中，53.2%为男性，中位年龄62岁（四分位间距：48 - 75岁）。WL评分预测7天结局的曲线下面积（AUC）值为0.956，CSSS评分为0.759，BISAP评分为0.871；预测30天结局时，WL评分的AUC值为0.941，CSSS评分为0.823，BISAP评分为0.901；预测不良预后结局时，WL评分的AUC值为0.792，CSSS评分为0.769，BISAP评分为0.731。
在AP患者中，WL、CSSS和BISAP评分是不良预后和死亡率的有效预测指标。WL评分在预测7天和30天死亡率及不良预后方面优于CSSS和BISAP评分。在WL评分之后，BISAP是预测死亡率的次优系统。对于预测不良预后，CSSS是仅次于WL的次优系统。基于四个实验室参数计算WL评分的简便性使其成为更优选择。
