Acute pancreatitis is an important gastrointestinal emergency that may lead to mortality, particularly in older patients. This retrospective, single-center observational prognostic validation study aims to compare the predictive performance of the National Early Warning Score 2 (NEWS-2) and NEWS-Calcium scores for in-hospital mortality in patients aged 65 years and older diagnosed with acute pancreatitis in the emergency department.
Electronic medical records of eligible patients will be reviewed retrospectively. Demographic characteristics, vital signs, serum calcium levels, clinical outcomes, intensive care unit admission, organ failure, length of hospital stay, and in-hospital mortality will be recorded. NEWS-2 will be calculated using vital parameters at admission, while the NEWS-Calcium score will be obtained by adding a calcium-based score to NEWS-2.
The primary outcome will be in-hospital mortality. Secondary outcomes will include intensive care unit admission, severe acute pancreatitis, persistent organ failure, and length of hospital stay. The predictive performances of the scores will be compared using ROC curve analysis, AUC values, and the DeLong test. This study aims to identify the most appropriate early prognostic score for older patients with acute pancreatitis and to support clinical decision-making in emergency settings.
Age 65 years or older.
Admission to the emergency department with a diagnosis of acute pancreatitis during the study period.
Diagnosis of acute pancreatitis established according to clinical presentation, serum pancreatic enzyme levels, and/or imaging findings.
Availability of admission vital parameters required to calculate the National Early Warning Score 2 (NEWS-2).
Age younger than 65 years.
Absence of a confirmed diagnosis of acute pancreatitis.
Missing data required to calculate NEWS-2 or NEWS-Calcium scores.
Missing serum calcium measurement at admission.
The study population will consist of patients aged 65 years and older who were admitted to the emergency department and diagnosed with acute pancreatitis during the predefined study period. Eligible patients will be identified retrospectively through electronic medical records. Patients with available admission vital signs, serum calcium levels, and in-hospital outcome data will be included. Patients with missing data required for calculation of NEWS-2 or NEWS-Calcium scores, unavailable outcome data, or transfer before outcome assessment will be excluded. Only the first eligible admission will be analyzed for patients with recurrent admissions.
Case-control
Cross-sectional
Retrospective Calculation of NEWS-2 Score
Other interventionhe National Early Warning Score 2 (NEWS-2) will be calculated retrospectively using physiological parameters recorded at emergency department admission, including respiratory rate, oxygen saturation, systolic blood pressure, pulse rate, level of consciousness, body temperature, and supplemental oxygen use. No intervention will be administered to patients as part of this study.
In-Hospital Mortality
n-hospital mortality will be defined as death occurring during the index hospitalization among patients aged 65 years and older diagnosed with acute pancreatitis in the emergency department. Mortality status will be obtained retrospectively from electronic medical records.
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