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Peer-reviewedCC BYSao Paulo medical journal = Revista paulista de medicina

Associations between the development of severe acute pancreatitis and the risk scores on admission and inflammatory biomarkers in older patients: a retrospective cohort study

  • Nafis Vural1
  • Murat Duyan2
  • Elif Ertas3
  • Hasan Can Guven4
  • Mehmet Akcimen2
  • Osman Gürsoy Unal4
4 affiliations
  1. 1MD. Emergency Medicine Specialist, Department of Emergency Medicine, Konya Training and Research Hospital, Baskent University, Konya, Türkiye.
  2. 2MD. Associate Professor, Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Türkiye.
  3. 3PhD. Assistant Professor, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Atlas University, Istanbul, Türkiye.
  4. 4MD. Emergency Medicine Specialist, Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Türkiye.
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Abstract

Background

Acute pancreatitis is an important cause of morbidity and mortality among patients presenting to the emergency department with abdominal pain.Objectives

In this study, we aimed to compare the diagnostic performance of the Bedside Index for Severity in Acute Pancreatitis (BISAP) and Emergency Department SpO2, Age, and Systemic Inflammatory Response Syndrome (ED-SAS) score for predicting severe acute pancreatitis (SAP) in older patients diagnosed with acute pancreatitis in the emergency department. The predictive performances of inflammatory markers, including the neutrophil-to-lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value, were also evaluated.Design and setting

This retrospective cohort study was conducted at a tertiary hospital in Türkiye.Methods

Factors associated with SAP were evaluated using univariate and multivariate binary logistic regression analyses; odds ratios with 95% confidence intervals were calculated.Results

The study included 400 older patients with acute pancreatitis (SAP group, n = 80; non-SAP group, n = 320). The neutrophil-to-lymphocyte ratio, SII, SIRI, pan-immune-inflammation value, ED-SAS score, and BISAP showed good discrimination for SAP, yielding area under the receiver operating characteristic curve values of 0.82, 0.83, 0.85, 0.86, 0.81, and 0.82, respectively. In the multivariate analysis, an SII of > 5796.25 (odds ratio, 13.59), SIRI of > 11.79 (odds ratio, 7.57), ED-SAS score of > 1 (odds ratio, 5.41), and BISAP of > 1 (odds ratio, 2.91) remained independently associated with SAP.Conclusion

The SII, SIRI, ED-SAS score, and BISAP may support early risk stratification for SAP in geriatric pancreatitis. These parameters should be interpreted alongside clinical assessment rather than used as stand-alone diagnostic criteria.

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Cite

BibTeXRIS
BibTeX
@article{vural2026associations,
  title = {{Associations between the development of severe acute pancreatitis and the risk scores on admission and inflammatory biomarkers in older patients: a retrospective cohort study}},
  author = {Nafis Vural and Murat Duyan and Elif Ertas and Hasan Can Guven and Mehmet Akcimen and Osman Gürsoy Unal},
  journal = {Sao Paulo medical journal = Revista paulista de medicina},
  year = {2026},
  month = oct,
  doi = {10.1590/1516-3180.2026.3603.14082026},
  url = {https://europepmc.org/article/PMC/PMC13705630},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Associations between the development of severe acute pancreatitis and the risk scores on admission and inflammatory biomarkers in older patients: a retrospective cohort study
AU  - Nafis Vural
AU  - Murat Duyan
AU  - Elif Ertas
AU  - Hasan Can Guven
AU  - Mehmet Akcimen
AU  - Osman Gürsoy Unal
PY  - 2026
DA  - 2026/10/23
JO  - Sao Paulo medical journal = Revista paulista de medicina
DO  - 10.1590/1516-3180.2026.3603.14082026
UR  - https://europepmc.org/article/PMC/PMC13705630
AB  - Background  Acute pancreatitis is an important cause of morbidity and mortality among patients presenting to the emergency department with abdominal pain.Objectives  In this study, we aimed to compare the diagnostic performance of the Bedside Index for Severity in Acute Pancreatitis (BISAP) and Emergency Department SpO2, Age, and Systemic Inflammatory Response Syndrome (ED-SAS) score for predicting severe acute pancreatitis (SAP) in older patients diagnosed with acute pancreatitis in the emergency department. The predictive performances of inflammatory markers, including the neutrophil-to-lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value, were also evaluated.Design and setting  This retrospective cohort study was conducted at a tertiary hospital in Türkiye.Methods  Factors associated with SAP were evaluated using univariate and multivariate binary logistic regression analyses; odds ratios with 95% confidence intervals were calculated.Results  The study included 400 older patients with acute pancreatitis (SAP group, n = 80; non-SAP group, n = 320). The neutrophil-to-lymphocyte ratio, SII, SIRI, pan-immune-inflammation value, ED-SAS score, and BISAP showed good discrimination for SAP, yielding area under the receiver operating characteristic curve values of 0.82, 0.83, 0.85, 0.86, 0.81, and 0.82, respectively. In the multivariate analysis, an SII of > 5796.25 (odds ratio, 13.59), SIRI of > 11.79 (odds ratio, 7.57), ED-SAS score of > 1 (odds ratio, 5.41), and BISAP of > 1 (odds ratio, 2.91) remained independently associated with SAP.Conclusion  The SII, SIRI, ED-SAS score, and BISAP may support early risk stratification for SAP in geriatric pancreatitis. These parameters should be interpreted alongside clinical assessment rather than used as stand-alone diagnostic criteria.
SN  - 1516-3180
SN  - 1806-9460
ER  -