Yunus Emre Güzel1,2, Nese Çolak1, Ahmet Can Okuv1, Sefer Teymuroğlu1,3, Muhammet İkbal Teke1,4

1Department of Emergency Medicine, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
2Department of Emergency Medicine, Adiyaman Education and Research Hospital, Adiyaman, Türkiye
3Department of Radiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
4Department of Child and Adolescent Psychiatry, School of Medicine, Hacettepe University, Ankara, Türkiye

Keywords: Acute pancreatitis, Bedside Index of Severity in Acute Pancreatitis, Chinese Simple Scoring System, emergency department, mortality, outcomes, scoring systems, WL


OBJECTIVES: Several scoring systems are used to predict prognosis in acute pancreatitis (AP), but their predictive success varies. This study compares the validity of the commonly used Bedside Index of Severity in AP (BISAP) score with the newly developed WL score and the Chinese Simple Scoring System (CSSS) score in predicting mortality and unfavorable prognostic outcomes in AP patients.

METHODS: This retrospective descriptive study included all AP patients presenting to the emergency department from June 2, 2019, to June 2, 2022. Patient demographics, vital signs, laboratory values, and imaging findings were recorded, and WL, CSSS, and BISAP scores were calculated. The effectiveness of these scores in predicting adverse outcomes and mortality was compared.

RESULTS: Among 357 patients, 53.2% were male, with a median age of 62 years (interquartile range: 48–75). Area under the curve (AUC) values for 7 day outcomes were 0.956 for WL, 0.759 for CSSS, and 0.871 for BISAP; for 30 day outcomes, AUC values were 0.941 for WL, 0.823 for CSSS, and 0.901 for BISAP; and for poor prognostic outcomes, AUC values were 0.792 for WL, 0.769 for CSSS, and 0.731 for BISAP.

CONCLUSION: In AP patients, WL, CSSS, and BISAP scores are effective predictors of unfavorable prognosis and mortality. WL score outperforms the CSSS and BISAP scores in predicting 7 day and 30 day mortality and poor prognosis. After WL, BISAP is the second best system for predicting mortality. For predicting unfavorable prognoses, CSSS is the second best system after WL. The simplicity of calculating the WL score based on four laboratory parameters makes it a preferable choice.

How to cite this article: Güzel YE, Çolak N, OkuvAC, Teymuroğlu S, Teke Mİ. Comparing prognostic scoring systems in acute pancreatitis: Bedside Index of Severity in Acute Pancreatitis, WL, and Chinese Simple Scoring System Scores. Turk J Emerg Med 2024;24:165-71.

Ethics Committee Approval

The study was started after obtaining the permission of the Dokuz Eylul University Faculty of Medicine Clinical Studies Ethics Committee (Decision no: 2022/22-18 Date: 29.06.2022).

Author Contributions

The manuscript has been read and approved by all authors. Conceptualization: YEG, NC, ACO, ST, and MIT, Data curation: YEG, ACO, ST, and MIT, Formal analysis: YEG, NC, and ACO, Investigation: YEG and NC, Methodology: YEG and NC, Project administration: YEG and NC, Supervision: YEG and NC, Roles/Writing – Original draft: YEG, NC, ACO, ST, and MIT, and Writing – Review and editing: YEG, NC, ACO, ST, and MIT.

Conflict of Interest

None declared.

Financial Disclosure