Background: Charlson Comorbidity Index (CCI) is the common and valid method to predict mortality by classifying comorbidities such as cardiovascular, metabolic, renal, hepatic, pulmonary diseases, and malignancy. Novel risk factors are not included in the Charlson Comorbidity Index, such as thyroid hormone index (FT3/FT4 ratio) and serum albumin levels. In the present study, we aimed to assess whether the thyroid hormone index and albumin are useful clinical parameters in short and long-term mortality. Methods: In the retrospective cohort study with a 5 year follow up, the data of 1292 patients who were hospitalized between January 1st–June 30th of 2014 were examined. Three months mortality as short term and 5-year mortality as long term were evaluated. Results: Three months and 5 years mortality rates for 1064 patients were analyzed. We showed that hypoalbuminemia and thyroid hormone index had statistically significant effects on short and long-term mortality. According to ROC analysis it was demonstrated that the scoring system including biochemical parameters such as thyroid hormone index and serum albumin level was more significant for 3-month mortality. In addition, both scoring systems are equal in demonstrating long-term mortality. Conclusion: Thyroid hormone index and albumin could improve the prognostic performance of the original Charlson Comorbidity Index in short term mortality. The combined score may offer improvements in comorbidity summarization over existing scores.

Background/Objectives: Acute pancreatitis (AP) is characterized by pancreatic gland inflammation, and its clinical course ranges from mild to severe. Predicting the severity of AP early and reliably is important. In this study, we investigate the potential use of the Controlling Nutritional Status (CONUT) score as a prognostic marker in acute pancreatitis. Methods: We examined 336 patients who had been hospitalized with an AP diagnosis in the internal medicine clinic. The patients included in the study were followed up for 5 years. The study analyzed the specific variables of age, gender, and AP etiology as recorded biochemical parameters for all study participants and calculated the effects of age, sex, Bedside Index of Severity in AP (BISAP), the revised Atlanta classification, and the CONUT score on mortality. Results: When compared with surviving patients, non-surviving patients had higher scores for BISAP, CONUT, and the Atlanta Classification (p ˂ 0.001). In the non-surviving group, hemoglobin, lymphocyte, and albumin levels were significantly lower and creatinine, uric acid, and procalcitonin levels were significantly higher compared to the surviving group (p ˂ 0.001, 0.003, ˂0.001, ˂0.001, 0.005, ˂0.001, respectively). The multivariate analysis showed a significant association of mortality with age, CONUT, and BISAP scores (p ˂ 0.003, 0.001, 0.012 respectively). The CONUT score was separated into two groups based on the median value. The predicted survival time in the group with a CONUT score > 2 (53.8 months) was significantly lower than in the group with a CONUT score ≤ 2 (63.8 months). The cumulative incidence of all-cause mortality was significantly higher in the patients with higher CONUT scores. Conclusions: This study has assigned the CONUT score as an independent risk factor for mortality in AP.

Objective: Fat accumulation in the liver and pancreas are clinical manifestations of metabolic syndrome associated with inflammation. It aimed to investigate the effects of the computed tomography (CT) estimated non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreas disease (NAFPD) on the development of acute pancreatitis in this study. Patients and methods: This retrospective and cross-sectional study consisted of 194 participants admitted to the hospital with an abdominal pain complaint and underwent an abdominal CT scan during the investigation of the differential diagnosis. Medical database records of patients were investigated. Groups were consisted of according to the presence of acute pancreatitis as study and control. Attenuation measurements of the liver and pancreas were determined according to abdominal CT. Results: A statistical significance was observed for the development of acute pancreatitis when patients with normoglycemia were compared to patients with prediabetes and diabetes. Percentages of NAFLD and NAFPD according to the median of CT attenuation difference between pancreas and spleen values were elevated in the study group. A logistic regression model revealed that prediabetes, type 2 diabetes, NAFLD, and NAFPD, according to median value, were risk factors for acute pancreatitis (p<0.001, =0.001, =0.02, and =0.022). Discussion: NAFLD and NAFPD, according to the median value of patients without pancreatitis, were determined as independent risk factors for the development of acute pancreatitis.

Objectives: Increased vitamin B12 levels are associated with mortality. We aim to define the relationship between B12 levels and 6 months,12 months, and 48 months mortality. Methods: We investigated 455 patients hospitalized in the internal medicine clinic from 01.01.2014 to 30.06.2014. Patients younger than 18 years old, with chronic heart failure, hematological malignancies, solid tumors, chronic liver disease, and end-stage kidney disease were excluded. Patients with a vitamin B12 below and below the reference range were excluded. Laboratory parameters and vitamin B12 levels were compared between survival and non-survival groups at 6 months,12 months, and 48 months. Mortality data for 6 months,12 months, and 48 months after the first hospitalization day were obtained. Results: The mortality percentages of patients were evaluated on the 6th, 12th, and 48th months. Age, complete blood count parameters (hemoglobin, white blood cell, and platelet), acute phase reactants, and serum vitamin B12 levels were compared between patient groups. Increased vitamin B12 level was found to be correlated with acute phase reactants (C reactive protein, albumin, ferritin, sedimentation) and hemoglobin. Regression analysis revealed that increased vitamin B12 levels, ferritin, sedimentation, white blood cell, and low albumin levels were statistically significant in 6th-month mortality. High white blood cell count and low albumin levels were statistically significantly correlated with mortality in the 12th and 48th months. Conclusion: Increased vitamin B12 levels were effective in predicting 6-month, 12-month, and 48-month mortality. Age-decreased albumin levels, acute phase reactants, and increased B12 levels were identified in hospitalized patients as risk factors for short, mid-term, and long-term mortality.