Predicting Severity in Acute Pancreatitis: A Never-Ending Quest

Other scoring systems are time-consuming, making it difficult to implement them in the emergency department. [...]most algorithms have failed to achieve reasonable predictive values [3]. [...]two scoring systems developed in critically ill patients were shown to be useful in AP. In this prospective study, 180 patients with mild AP according to HAPS and Imrie scores were selected and submitted to CT scans and blood tests at 12 and 72 h. The patients were then graded according to the Balthazar score (A–E), and the most relevant biomarkers (amylase, lipase, and CRP) were recorded. [...]the results and conclusions presented by the authors have several limitations: the majority of patients enrolled had AP of biliary origin; the follow-up of these patients appears to be short; and the presence and extent of pancreatic and peripancreatic necrosis may not be defined clearly on imaging during the first few days of disease, raising questions about the timing of radiologic re-evaluation.