Objective To explore the value of NEWS scoring in predicting the condition and evaluating the prognosis of elderly acute pancreatitis (AP).

Methods A total of 216 elderly patients with AP was selected as the research subjects, and divided into the SAP group (61 cases) and non-SAP group (155 cases) according to the severity of the disease. According to the survival status of the patients after 28 days of admission, they were divided into the survival group (200 cases) and death group (16 cases). After admission, the clinical data of patients were collected, which included the age, gender, Acute Physiological Function and Chronic Health Evaluation II (APACHE II) score, AP Severity Bedside Index (BISAP), Ranson score, NEWS score and lactate value. The admission data were analyzed using the independent sample t-test. The Person correlation analysis was conducted between the NEWS score and APACHE II score, Ranson score, BISAP score, lactic acid. The ROC curve was drawn to predict the severity of disease and 28-day mortality in AP patients. The Kaplan-Meier survival curve was used to analyze the cumulative survival rate under risk stratification at different NEWS score levels.

Results There was no statistical significance in the gender between the non-SAP group and SAP group (P ＞ 0.05). The NEWS score, lactate level, Ranson score, BISAP score and APACHEⅡ score in the SAP group were significantly higher than those in non-SAP group (P ＜ 0.01). There was no statistical significance in the gender between the survival group and death group (P ＞ 0.05). The NEWS score, Ranson score, lactate level, BISAP score and APACHEⅡ score in the death group were significantly higher than those in survival group (P ＜ 0.01). The NEWS score of AP patients was significantly positively correlated with the APACHE II score, Ranson score, BISAP score and lactic acid (r = 0.845, 0.866, 0.758, 0.883, P ＜ 0.01). The area under the ROC curve (AUC) of the NEWS score for predicting SAP and risk of 28-day mortality were 0.609 (95%CI: 0.574–0.644) and 0.794 (95%CI: 0.753–0.835), respectively. The optimal cut-off values were 0.222 and 0.477, the corresponding NEWS scores were 8.5 and 7.5, the sensitivities were 49.00% and 81.20%, and the specificities were 83.20% and 66.50%, respectively. Combined with the optimal cut-off value of the ROC curve for predicting the occurrence of SAP and 28-day mortality based on the NEWS score, the median value of 8.00 was taken as the latest optimal cut-off value for the 28-day cumulative survival rate analysis of SAP, and the Kaplan-Meier survival curve was plotted showed that the 28-day cumulative survival rate of the group with NEWS score ＞ 8.00 was significantly lower than that of the group with NEWS score ≤8.00 (Log-Rank test: χ² = 37.31, P ＜ 0.01).

Conclusions The NEWS score is a good predictor of the severity of disease and risk of death in patients with AP, and can be used as a supplement to the clinical assessment system for the condition of AP patients. Especially for elderly AP patients with a NEWS score ＞ 8.00, the risk of short-term death is relatively high, which is worthy of clinical promotion and application.