Comparison of CCI, BISAP and APACHE II Scoring Systems to Predict Severe Disease in Patients with Mild Acute Pancreatitis: A Retrospective Observational Study

Background: Early recognition and treatment of patients with acute pancreatitis (AP) is important to improve prognosis and increase survival. Many scoring systems have been developed to assess the prognosis and disease severity in AP. The aim of this study was to compare the effectiveness of the Charlson Comorbidity Index (CCI), Bedside Index for Severity in AP (BISAP), and Acute Physiology and Chronic Health Evaluation (APACHE II) scores in predicting 30-day mortality and the development of severe AP (SAP) in patients with mild AP (MAP). Materials and Methods: This single-center, retrospective, and observational study was conducted with adult patients classified as MAP within 48 hours of arrival at the emergency department. Areas under the receiver operating characteristic curve (AUC) were calculated for each score to evaluate the effectiveness of the scores in predicting the development of SAP and 30-day mortality. Results: A total of 1419 patients with MAP were included in the study between January 01, 2018 and April 01, 2022. In MAP patients, SAP development rate was 14.4%, and the 30-day mortality rate was 1.8%. The accuracy of CCI (AUC=0.797±0.015) in predicting the development of SAP was significantly higher than BISAP (AUC =0.736±0.019, p<0.001) and APACHE II (AUC =0.755±0.017, p=0.028) scores. The accuracy of CCI (AUC 0.797±0.040) in predicting 30-day mortality was similar to the BISAP score (AUC 0.790±0.041, p=0.844) and APACHE II score (AUC=0.762±0.042, p=0.417). There was no significant difference between the accuracy of BISAP and APACHE II scores in predicting the development of SAP (p= 0.196) and 30-day mortality (p=0.462). Conclusion: The CCI is a scoring system as effective as BİSAP and APACHE 2 scores in predicting the development of SAP and 30-day mortality in patients with MAP in our study population.