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Acute pancreatitis (AP) is an inflammatory disease of the pancreas that causes local damage and systemic inflammatory response. Some of the numerical scoring systems used in the intensive care unit for the assessment of critically ill patients such as APACHE II and MEWS score could be used for AP, beside the scoring systems specific to AP (Ranson score, Pancreas score, BISAP). Therefore, the aim of this study was to examine the significance of inflammatory biomarkers and scoring systems in the evaluation of the severity of AP and outcomes. The study was conducted as a cohort prospective study, examining patients with AP, of both sexes. Laboratory analyses, as well as the scoring systems: Ranson, Pancreas score, Bedside Index of Severity in Acute Pancreatitis (BISAP), and Acute Physiology and Chronic Health Evaluation II (APACHE II) were collected on day zero and 48h after admission. The study included 50 patients of whom 8 died. The most reliable score for predicting AP severity was APACHE II0 and 48AUROC (0.753; 0.768) in relation to the inflammatory biomarkers. For initial prediction of the treatment outcome, APACHE II0, BISAP0, and CRP0 AUROC (0.813; 0.807; 0.753) had the highest discrimination rates and after 48h, APACHE II48, Ranson48, BISAP48, and Pancreas48 AUROC (0.917; 0.856; 0.789; 0.729). There was a statistically significant correlation between CRP0 and BISAP0 (p=0.006) and between PCT and all day-zero scores. All tested screening systems showed reliability in predicting AP severity and treatment outcomes. The best predictive power was demonstrated by the APACHE II score.

The aim of this study was to determine the significance of the use of the BISAP score, which is specific for patients with AP, in relation to the application of the MEWS score that is important for assessing the condition of critically ill patients in intensive care units, but is not specific for patients with AP. The research was conducted as a cohort prospective study and included patients of both sexes, older than 18 and diagnosed with AP. BISAP and MEWS score were monitored at least at four time points: on admission to the hospital (zero), 48 hours, 72 hours and 7 days after admission to the hospital. High levels of discrimination between patients with fatal outcome and cured patients are determined in both cases, with discrimination at MEWS being somewhat higher than BISAP score. The BISAP0 had the best discrimination for BISAP score, AUROC (0.807) and also MEWS0 for MEWS score, AUROC (0.899). In our research, the highest sensitivity was shown by BISAP7d (92.1%) and MEWS48 (88.1%), and a high specificity of 87.5% had BISAP score, 48h, 72h and MEWS score at all four points of measurement. BISAP score has a better prognostic value in relation to the form of pancreatitis, the development of complications and the outcome. However, the calculation of the MEWS score is based on monitoring the basic vital parameters so that its application is much simpler and does not require additional costs.