Shi PN, Song ZZ, He XN, Hong JM. Evaluation of scoring systems and hematological parameters in the severity stratification of early-phase acute pancreatitis. World J Gastroenterol 2025; 31(15): 105236 [DOI: 10.3748/wjg.v31.i15.105236]
Corresponding Author of This Article
Jie-Ming Hong, MD, Chief Physician, Department of Gastroenterology, Ningbo Yinzhou No. 2 Hospital, No. 998 Qianhe North Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. jm_hong@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 21, 2025; 31(15): 105236 Published online Apr 21, 2025. doi: 10.3748/wjg.v31.i15.105236
Evaluation of scoring systems and hematological parameters in the severity stratification of early-phase acute pancreatitis
Pei-Na Shi, Zhang-Zhang Song, Xu-Ni He, Jie-Ming Hong
Pei-Na Shi, Zhang-Zhang Song, Xu-Ni He, Jie-Ming Hong, Department of Gastroenterology, Ningbo Yinzhou No. 2 Hospital, Ningbo 315000, Zhejiang Province, China
Author contributions: Shi PN and Hong JM designed the research; Song ZZ and He XN contributed to the data collection; Shi PN and He XN analyzed the data; Shi PN, Song ZZ, and Hong JM wrote the paper. All authors reviewed the manuscript.
Institutional review board statement: The study was approved by the Human Ethics Committee of the Yinzhou No. 2 Hospital (approval number: Y2024-50).
Clinical trial registration statement: This clinical trial was registered at ClinicalTrials.gov, No. ChiCTR2500098956.
Informed consent statement: Informed consent statement has been applied for exemption for this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie-Ming Hong, MD, Chief Physician, Department of Gastroenterology, Ningbo Yinzhou No. 2 Hospital, No. 998 Qianhe North Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. jm_hong@126.com
Received: January 18, 2025 Revised: February 24, 2025 Accepted: March 25, 2025 Published online: April 21, 2025 Processing time: 92 Days and 5.1 Hours
Abstract
BACKGROUND
Acute pancreatitis (AP) is an emergency gastrointestinal disease that requires immediate diagnosis and urgent clinical treatment. An accurate assessment and precise staging of severity are essential in initial intensive therapy.
AIM
To explore the prognostic value of inflammatory markers and several scoring systems [Acute Physiology and Chronic Health Evaluation II, the bedside index of severity in AP (BISAP), Ranson’s score, the computed tomography severity index (CTSI) and sequential organ failure assessment] in severity stratification of early-phase AP.
METHODS
A total of 463 patients with AP admitted to our hospital between 1 January 2021 and 30 June 2024 were retrospectively enrolled in this study. Inflammation marker and scoring system levels were calculated and compared between different severity groups. Relationships between severity and several predictors were evaluated using univariate and multivariate logistic regression models. Predictive ability was estimated using receiver operating characteristic curves.
RESULTS
Of the 463 patients, 50 (10.80%) were classified as having severe AP (SAP). The results revealed that the white cell count significantly increased, whereas the prognostic nutritional index measured within 48 hours (PNI48) and calcium (Ca2+) were decreased as the severity of AP increased (P < 0.001). According to multivariate logistic regression, C-reactive protein measured within 48 hours (CRP48), Ca2+ levels, and PNI48 were independent risk factors for predicting SAP. The area under the curve (AUC) values for the CRP48, Ca2+, PNI48, Acute Physiology and Chronic Health Evaluation II, sequential organ failure assessment, BISAP, CTSI, and Ranson scores for the prediction of SAP were 0.802, 0.736, 0.871, 0.799, 0.783, 0.895, 0.931 and 0.914, respectively. The AUC for the combined CRP48 + Ca2+ + PNI48 model was 0.892. The combination of PNI48 and Ranson achieved an AUC of 0.936.
CONCLUSION
Independent risk factors for developing SAP include CRP48, Ca2+, and PNI48. CTSI, BISAP, and the combination of PNI48 and the Ranson score can act as reliable predictors of SAP.
Core Tip: Acute pancreatitis (AP) is an emergency gastrointestinal disease that requires immediate diagnosis and urgent clinical treatment. An accurate assessment and staging of severity are essential in initial intensive therapy. This study systematically explored the prognostic value of inflammatory markers and several scoring systems in severity stratification of early-phase AP. 463 patients with AP were enrolled in this study. The results revealed that C-reactive protein measured within 48 hours, calcium and prognostic nutritional index measured within 48 hours were independent risk factors for predicting severe AP. Computed tomography severity index, bedside index of severity in AP, and the combination of prognostic nutritional index measured within 48 hours and the Ranson score can act as reliable predictor of severity AP.
