A New Simple Scoring System for Early Prediction of Severe Acute Pancreatitis

Acute pancreatitis (AP) is an inflammatory condition with rising incidence, often resulting in severe complications and increased mortality, particularly when accompanied by organ failure. Early identification of patients at risk for severe AP is essential for timely intervention. Current scoring systems like Ranson's, BISAP, and APACHE-II, though useful, have limitations in terms of time and specificity. We aimed to identify a simple and early scoring system to predict severe AP.

In this single-center study conducted over two years, patients diagnosed with AP within 72 h of symptom onset were enrolled. Initial clinical and laboratory data were prospectively collected according to established criteria, including BISAP, APACHE-II, and Ranson's. Multivariate logistic regression analyses were performed to identify independent risk factors for severe AP, which were then used to develop a new scoring system.

In our population of 424 patients (8.5% severe), we identified key clinical and laboratory markers-blood urea nitrogen (BUN), neutrophil-to-lymphocyte ratio (NLR), and heart rate-as independent predictors of severe AP. Based on these factors, we developed the BHN scoring system, which demonstrated non-inferior sensitivity (91.7%) and specificity (83.3%) for predicting severe disease, compared to more complex systems BISAP, Ranson's, and APACHE-II.

The BHN score offers a simple, accessible tool in a variety of clinical settings, improving early risk stratification. External validation and further exploration of its use in mortality prediction are needed, but BHN presents a promising alternative for guiding early treatment decisions in acute pancreatitis.