Farrell PR, Hornung L, Farmer P, et al. - In the present study, the researchers sought to validate and optimize a severity prediction model for acute pancreatitis (AP) and to analyze blood urea nitrogen (BUN) level changes from admission as a severity predictor. Patients from 2 hospitals were included for the validation model (Children's Hospital of the King's Daughters and Children's National Hospital). The validation cohort involved 73 patients; 22 (30%) with either severe or moderately severe AP, combined into the all severe AP (SAP) group. It was noted that patients with SAP had higher BUN and lower albumin. In total, 176 AP patients were analyzed at 24–48 hours; 39 (22%) met criteria for SAP. The authors externally validated the prior model with admission BUN levels and further optimized it by adding albumin. They also observed that persistent elevation of BUN is linked to development of SAP. Findings suggested that the model may be used to risk stratify patients with AP on admission and again at 24 to 48 hours.