title: Comparison and validation of scoring systems in a cohort of patients treated for biliary acute pancreatitis.
abstract: OBJECTIVE
  There are a few prospective studies assessing the severity of acute pancreatitis with exclusive criteria for biliary etiology. The aim of this study was to assess the reliability of prediction of the severity and mortality of acute biliary pancreatitis by using the Ranson, Acute Physiology And Chronic Health Evaluation II and III, Simplified Acute Physiology Score II, and Mortality Probability Model (MPM) II systems.
  
  
  METHODS
  Fifty-eight patients with acute biliary pancreatitis were studied prospectively. Disease severity scores and mortality predictions were calculated using the collected data in the first 24 hours of admission and for Ranson score in the first 48 hours. Discrimination and calibration characteristics of each system were determined by using area under receiver operating characteristics curve and Hosmer-Lemeshow goodness-of-fit test, respectively.
  
  
  RESULTS
  Among 58 patients included, there were 4 mortalities (6.8%). Fifteen patients (25.8%) had severe disease, and 5 patients (8.6%) had systemic and local complications. All systems had reliable power of discrimination and calibration. Among systems tested MPM II was the best performing as far as discrimination, and calibration characteristics are considered. The items of MPM II that were positive in patients with severe pancreatitis were those related to systemic perfusion.
  
  
  CONCLUSIONS
  Mortality Probability Model II predicted mortality at admission is better than the other systems in predicting the severity of pancreatitis. Results also indicate the important role of systemic perfusion at the early phases of acute pancreatitis in the progression of disease.
authors.affiliation: Fifth Department of Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Göçmen
authors.forename: Yusuf Alper
authors.initials: YA
authors.lastname: Klc
authors.forename: Omer
authors.initials: O
authors.lastname: Yoldaş
authors.forename: Tamer
authors.initials: T
authors.lastname: Ertan
authors.forename: Nazile
authors.initials: N
authors.lastname: Karaköse
authors.forename: Mahmut
authors.initials: M
authors.lastname: Koç
authors.forename: Mesut
authors.initials: M
authors.lastname: Tez
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001660:Biliary Tract Diseases / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome