Diagnostic Performance of Scoring Systems in Non-Biliary Acute Pancreatitis Prognosis: A Comparative Analysis of Ranson and Balthazar Scores

Öz

Aim: The Ranson score (RS) and the Balthazar Computed Tomography Severity Index (CTSI) are commonly used to predict the severity and prognosis of acute pancreatitis (AP). However, the diagnostic superiority of these scoring systems in predicting the prognosis of non-biliary AP remains unclear. Therefore, this study aimed to compare the RS and CTSI in predicting the prognosis of non-biliary AP. Material and Methods: This retrospective study included 67 non-biliary AP patients who were followed at the Internal Medicine clinic of Hospital, between January 2021 and May 2023. The RS and CTSI were calculated based on the laboratory and radiological findings of the patients. The endpoints consisted of prolonged hospitalization (≥8 days), complications, and mortality. Results: The mean age of the patients was 50.1±8.3 years, and the majority were male (59.7%). Complications developed in 11.9% of the patients, prolonged hospitalization occurred in 26.9%, and death occurred in 6%. In predicting the risk of prolonged hospitalization and complications, CTSI exhibited superior diagnostic performance compared to RS (the area under the curve (AUC) = 0.590 vs. 0.856, p <0.05 for prolonged hospitalization, 0.615 vs. 0.786, p <0.05 for complications), while RS showed superior diagnostic performance in predicting the risk of mortality (AUC = 0.952 vs. 0.698, p <0.05). Conclusion: In the prognosis of non-biliary AP, both scoring systems have different diagnostic advantages compared to each other, and their combined use may provide more reliable results for the endpoints.

Anahtar Kelimeler

• Acute Pancreatitis
• Balthazar score
• Complication
• Ranson score
• Prognosis

Nonbiliyer Akut Pankreatit Prognozunda Skorlama Sistemlerinin Tanısal Performansı: Ranson ve Balthazar Skorlarının Karşılaştırmalı Analizi

Öz

Amaç: Akut pankreatitli hastalarda ciddiyetin ve prognozunu tahmin edilmesinde Ranson skoru (RS) ve Balthazar Bilgisayarlı Tomografi Şiddet İndeksini (CTSI) yaygın olarak kullanılmaktadır. Ancak, bu skorlama sistemlerinin biliyer olmayan akut pankreatitin prognouzu tahmin etmedeki tanısal üstünlükleri belirsizliğini korumaktadır. Bu nedenle, bu çalışmada nonbiliyer AP'nin prognozunu tahmin etmede RS ve CTSI'yi karşılaştırmayı amaçladık. Gereç ve Yöntemler: Bu retrospektif çalışmaya, Ocak 2021 ile Mayıs 2023 arasında İç Hastalıkları kliniğinde takip edilen 67 nonbiliyer AP hastası dahil edildi. RS ve CTSI, hastaların laboratuvar ve radyolojik bulgularına dayanarak hesaplanmıştır. Son noktalar, uzun süreli hastanede yatış (≥8 gün), komplikasyonlar ve mortaliteden oluşmaktadır. Bulgular: Hastaların ortalama yaşı 50.1±8.3 yıl olup, çoğunluğu erkek (%59.7) idi. Hastaların %11.9'unda komplikasyon gelişti, %26.9'unda uzun süreli hastanede yatış meydana geldi ve %6'sında ölüm gözlendi. Uzun süreli hastanede yatış ve komplikasyon riskini tahmin etmede CTSI, RS'ye göre üstün tanısal performans sergiledi (uzun süreli hastanede kalma için eğri altındaki alan (AUC) = 0.590 vs. 0.856, p <0.05, komplikasyonlar için AUC = 0.615 vs. 0.786, p <0.05), ancak RS mortalite riskini tahmin etmede daha üstün tanısal performans gösterdi (AUC = 0.952 vs. 0.698, p <0.05). Sonuç: Nonbiliyer AP'nin prognozunda her iki skorlama sisteminin birbirine göre farklı tanısal avantajları vardır ve bunların kombine kullanımı son noktalar için daha güvenilir sonuçlar sağlayabilir.

Anahtar Kelimeler

• Akut Pankreatit
• Balthazar skoru
• Komplikasyon
• Ranson skoru
• Prognoz

Kaynakça

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