Aktaş Ahmet Ali, Taşar Pınar, Siğirli Deniz, Kiliçturgay Sadık Ayhan
Department of General Surgery, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkiye.
Department of Biostatistics, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkiye.
Turk J Med Sci. 2025 Feb 24;55(2):451-460. doi: 10.55730/1300-0144.5989. eCollection 2025.
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).
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.
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-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-h NLR value was >13.33, the risk of severe AP was found to have increased by 5.85 times.
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.
本研究旨在证明不同评分系统和炎症标志物在预测急性胰腺炎（AP）的严重程度、局部并发症、胰腺坏死及死亡率方面的有效性。
回顾性分析357例根据修订的亚特兰大分类系统诊断为AP且已对胰腺炎严重程度进行分类的患者的数据。同时计算所有患者的急性生理与慢性健康状况评分系统II（APACHE II）、床边指数（BISAP）、改良CT严重指数（mCTSI）和兰森评分。通过ROC分析确定评分系统和炎症标志物的临界值后，比较AP的严重程度、局部并发症、坏死及死亡率。
在本研究中，2.8%的患者患有重症胰腺炎。发现48小时C反应蛋白（CRP）值>192mg/L的患者发生局部并发症的风险比低于该阈值的患者增加2.82倍，mCTSI评分>2的患者比评分≤2的患者增加48.96倍。发现兰森评分>4的患者死亡风险比评分≤4的患者增加9.07倍（p = 0.038）。观察到BISAP>2的患者发生重症AP的风险比≤2的患者增加11.79倍。在48小时中性粒细胞与淋巴细胞比值（NLR）值>13.33的患者中，发现重症AP的风险增加了5.85倍。
尽管在我们的研究中未能证明评分系统的优越性，但CRP和MCTSI用于预测局部并发症、BISAP用于预测严重程度、兰森评分用于预测死亡率是决定性变量。
