Comparison of Scoring Systems in Predicting Severity and Prognosis of Hypertriglyceridemia-Induced Acute Pancreatitis

  • Man Li
  • Xiao-kang Xing
  • Zhi-hua Lu
  • Feng GuoEmail author
  • Wei Su
  • Yong-jun Lin
  • Dong-hai Wang
Original Article



In China, hyperlipidemia is the second major reason of acute pancreatitis.


Comparison of Scoring Systems in identification patients at risk for severe acute pancreatitis (SAP), pancreatic necrosis (PNec), and infected pancreatic necrosis (IPN) early in the course of hypertriglyceridemia-induced acute pancreatitis (HTG-AP).


Predictive accuracy of scoring systems was measured by the area under the receiver operating characteristic curve (AUC) in a retrospective study. Pairwise AUC comparisons were performed to calculate the difference between scoring systems.


A total of 238 patients diagnosed with HTG-AP were included. Sixty patients (25.2%) were classified as SAP. Twenty-nine patients (12.2%) had evidence of PNec. Nine patients (3.8%) were diagnosed with IPN. One patient (0.4%) died during hospitalization. In predicting SAP in HTG-AP, the AUCs of APACHE-II, SOFA, SIRS, Ranson’s, BISAP, and MMS were 0.77, 0.83, 0.73, 0.88, 0.83, and 0.85, respectively; in predicting PNec, were 0.75, 0.77, 0.75, 0.86, 0.80, and 0.75, respectively; and in predicting IPN, were 0.92, 0.86, 0.76, 0.85, 0.84, and 0.87, respectively. Pairwise AUC comparisons revealed that Ranson’s, MMS, BISAP, and SOFA had higher accuracy than SIRS, Ranson’s and MMS had higher accuracy than APACHE-II in predicting SAP; Ranson’s had the same accuracy with BISAP, but higher than other four criteria in predicting PNec; APACHE-II had higher accuracy than SIRS in predicting IPN.


APACHE-II had high performance in predicting IPN, and all other score systems had medium performance in predicting SAP, PNec, and IPN in HTG-AP. Each score has its merit and weakness; BISAP may be the best criterion in predicting severity and prognosis of HTG-AP.


Hypertriglyceridemia Severe acute pancreatitis Pancreatic necrosis Infected pancreatic necrosis 



The study was not funded.

Complaince with Ethical Standards

Conflicts of interest

All authors declare no conflicts of interest.

Supplementary material

10620_2019_5827_MOESM1_ESM.xlsx (44 kb)
Supplementary material 1 (XLSX 45 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Man Li
    • 1
  • Xiao-kang Xing
    • 1
  • Zhi-hua Lu
    • 1
  • Feng Guo
    • 1
    Email author
  • Wei Su
    • 1
  • Yong-jun Lin
    • 1
  • Dong-hai Wang
    • 1
  1. 1.Department of Critical Care MedicineZhejiang University School of Medicine Sir Run Run Shaw HospitalHangzhouChina

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