The study’s goal was to test and refine a severity prediction model for acute pancreatitis (AP) and to look at blood urea nitrogen (BUN) level variations after admission as a severity predictor. Patients from two hospitals were included in the validation model. For the study of BUN at 24 to 48 hours, data from Children’s Hospital of the King’s Daughters and Cincinnati Children’s Hospital Medical Center were used. The validation cohort included 73 patients, 22 of whom had either severe or moderately severe AP, which was merged into the all severe AP (SAP) group. Patients with SAP exhibited greater BUN and decreased albumin levels. Admission BUN was shown to be a significant predictor of SAP. Combining BUN and albumin resulted in a more accurate prediction of SAP. At 24–48 hours, 176 AP patients were evaluated; 39 fulfilled SAP criteria. After 24 hours, those who developed SAP had substantially greater BUN. Elevated BUN levels throughout the first 24 to 48 hours were independently predictive of SAP development. Patients who developed SAP showed a substantially lower percentage drop in BUN from the time of admission to the time of discharge.

The preceding model was externally validated using admission BUN levels, and it was further improved by adding albumin. Researchers also discovered that sustained elevations in BUN are linked to the development of SAP.