Objectives : To evaluate the four scoring systems, including Ranson, BISAP, Glasgow, and APACHE II in the prognostic assessment of acute pancreatitis (AP) for elderly patients.
Methods: A retrospective study of 918 patients presenting with AP was done at Zhongda Hospital Southeast University, from January 2015 to December 2018. The patients were divided 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.
Results: The severity of the disease, and mortality are significantly different between the two groups (p-value <0.05), while the difference between the two groups about pancreatic necrosis is statistically insignificant (p-value =0.399). The differences of the AUCs (Area under curves) in prognostication of SAP (severe acute pancreatitis) between the two groups are statistically significant (p-value <0.05) for Ranson and APACHE II, while for BISAP and Glasgow, the differences are statistically insignificant. All the four scoring systems are effective and similar in prediction of pancreatic necrosis and death for both groups.
Conclusions: Prediction 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.