Abstract
BackgroundTo evaluate the ability of four scoring systems (Ranson, BISAP, Glasgow, and APACHE II) to predict outcomes of acute pancreatitis (AP) in elderly patients.MethodsThis 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.ResultsThe 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.ConclusionsPrediction 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.
Highlights
To evaluate the ability of four scoring systems (Ranson, bedside index of severity in acute pancreatitis (BISAP), Glasgow, and Acute Physiology and Chronic Health Evaluation (APACHE) II) to predict outcomes of acute pancreatitis (AP) in elderly patients
There was a statistical difference between the two groups of AP patients with coronary heart disease, because the incidence of coronary heart disease increases with age
Elderly AP patients are more susceptible to severe disease, organ failure and death while in hospital
Summary
To evaluate the ability of four scoring systems (Ranson, BISAP, Glasgow, and APACHE II) to predict outcomes of acute pancreatitis (AP) in elderly patients. There has been a large increase in admissions worldwide [3,4,5]. Many countries such as the United States, Japan, and China are facing accelerating population aging [6]. About 80% of the acute pancreatitis cases are mild and self-limited with no sequelae. The remaining cases deteriorate, and necrosis arises in parts of the pancreas and surrounding tissues. Despite the fact that mortality associated with acute pancreatitis has continuously reduced [7], the overall mortality of AP is 2–8% [8, 9]; when the cases become severe, mortality can reach to
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