EASIX as a moderately effective prognostic marker for mortality in severe acute pancreatitis: a retrospective study

Introduction The endothelial activation and stress index (EASIX) has been proposed as a surrogate laboratory index reflecting endothelial activation and stress. This study aimed to evaluate the prognostic value of EASIX in patients with severe acute pancreatitis (SAP). Methods This retrospective observational study analyzed 340 SAP patients hospitalized between December 2015 and December 2023. EASIX was calculated as LDH (U/L) × creatinine (mg/dL) / platelet count (10 9 /L). Regression analyses identified mortality predictors, which were incorporated into a prognostic model. Receiver operating characteristic (ROC) analysis compared the predictive performance of EASIX and the developed model. Results The overall mortality rate was 28.82%. Non-survivors exhibited significantly elevated EASIX levels compared to survivors ( p < 0.001). Multivariate analysis identified EASIX as an independent predictor of mortality ( p = 0.004), along with age, APACHE II score, white blood cell count, and shock. The predictive model incorporating these factors achieved an AUC of 0.77 (sensitivity 0.73, specificity 0.70), outperforming EASIX alone (AUC = 0.70). Conclusion EASIX is a moderately effective prognostic marker in SAP, with performance comparable to APACHE II. The developed predictive model incorporating EASIX shows improved accuracy over EASIX alone for mortality risk stratification, but external validation is needed before clinical application.