Comparison of different disease scoring systems and laboratory parameters in predicting disease severity in patients diagnosed with acute pancreatitis

In our study, we aimed to compare the predictive effects of SIRS criteria, BISAP, mGPS and qSOFA scoring systems and laboratory parameters such as NLR, PLR, RDW, MPV and CRP/Alb values on predicting disease severity in 198 patients hospitalized in the Gastroenterology Clinic of AÜTF Hospital with a diagnosis of AP. With this study, it was aimed to predict the severity of AP and reduce morbidity and mortality with appropriate treatment arrangements accordingly and to contribute to the literature with the data obtained as a result of the study. The data of 198 patients who were followed up in our Gastroenterology Clinic with a diagnosis of AP between November 01, 2021 and November 15, 2022 were retrospectively included in our study. Malignancy patients receiving active chemotherapy and patients with missing data were excluded from the study. SIRS criteria and BISAP, mGPS and qSOFA scoring systems and NLR, PLR, RDW, MPV and CRP/Alb values as laboratory parameters were evaluated during hospitalization. Patients were divided according to disease severity with the scoring systems and these groups were compared among themselves with laboratory parameters. Mortality, ICU stay and length of stay were compared according to the scoring systems. Data were analyzed with IBM SPSS V23. Significance level was taken as p<0.050. There were more male patients than female patients in the study. The age range was 21-92 years with a mean age of 57.47 years. Abdominal pain was the most common presenting complaint. The most common etiologic cause was found to be biliary. The mean value of NLR was 9.15 and the mean value of PLR was 224.18. The mean value of RDW was 14.02, while the mean value of MPV was 10.34. The mean value of albumin was 38.04, the mean value of CRP was 58.16 and the mean value of Crp/Alb was 0.00166. The data were similar to the literature except for the mean value of MPV. Those with ≥2 SIRS criteria were included in the SIRS positive group. Those with BISAP score and mGPS score ≥3 were included in the severe disease group. In qSOFA, those with a score of ≥2 were as considered serious patients and there was only one patient. In our study, no comparison could be made because there were not enough patients according to qSOFA score. NLR was found to be statistically significantly higher in SIRS positive and severe disease group according to mGPS score, PLR was found to be statistically significantly higher in mGPS severe disease group, RDW was found to be statistically significantly higher in severe AP group and SIRS positive patients according to BISAP score, CRP/Alb was found to be statistically significantly higher in severe disease group and SIRS positive patients according to BISAP and mGPS. ICU admission and mean duration of hospitalization were found to be statistically significantly higher in severe disease group according to mGPS score. Mild and severe disease groups in the scoring systems evaluated in our study were compared between each other and it was found that the scoring systems were not correlated among themselves to predict disease severity. Some of our data were found to be consistent with the literature. In the literature review, there was no study directly examining the relationship between SIRS score and AP and our study is the first in the literature about the relationship between SIRS and AP severity. Although there have been similar studies before, the predictive value of CRP/Alb was seen more clearly in our study due to the higher number of scoring systems which we used to compare than the other studies in the literature.