Resumen en Inglés:

ABSTRACT BACKGROUND: Acute pancreatitis is an important cause of morbidity and mortality among patients presenting to the emergency department with abdominal pain. OBJECTIVES: In this study, we aimed to compare the diagnostic performance of the Bedside Index for Severity in Acute Pancreatitis (BISAP) and Emergency Department SpO2, Age, and Systemic Inflammatory Response Syndrome (ED-SAS) score for predicting severe acute pancreatitis (SAP) in older patients diagnosed with acute pancreatitis in the emergency department. The predictive performances of inflammatory markers, including the neutrophil-to-lymphocyte ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value, were also evaluated. DESIGN AND SETTING: This retrospective cohort study was conducted at a tertiary hospital in Türkiye. METHODS: Factors associated with SAP were evaluated using univariate and multivariate binary logistic regression analyses; odds ratios with 95% confidence intervals were calculated. RESULTS: The study included 400 older patients with acute pancreatitis (SAP group, n = 80; non-SAP group, n = 320). The neutrophil-to-lymphocyte ratio, SII, SIRI, pan-immune-inflammation value, ED-SAS score, and BISAP showed good discrimination for SAP, yielding area under the receiver operating characteristic curve values of 0.82, 0.83, 0.85, 0.86, 0.81, and 0.82, respectively. In the multivariate analysis, an SII of > 5796.25 (odds ratio, 13.59), SIRI of > 11.79 (odds ratio, 7.57), ED-SAS score of > 1 (odds ratio, 5.41), and BISAP of > 1 (odds ratio, 2.91) remained independently associated with SAP. CONCLUSION: The SII, SIRI, ED-SAS score, and BISAP may support early risk stratification for SAP in geriatric pancreatitis. These parameters should be interpreted alongside clinical assessment rather than used as stand-alone diagnostic criteria.