APSevLM: Acute Pancreatitis Severity Language Model.

Approximately one-fifth of patients with acute pancreatitis (AP) develop severe forms, which are associated with high mortality rates, making early prediction of severity crucial for effective patient management. In this study, we present APSevLM (Acute Pancreatitis Severity Language Model), a large language model (LLM)-based approach that integrates admission-time clinical data, imaging reports, and expert knowledge to predict AP severity at an early stage. Through a comprehensive evaluation using data from over five hundred patients, APSevLM outperforms traditional scoring systems (BISAP and MCTSI), conventional machine learning algorithms, and state-of-the-art deep learning models, achieving an AUC of 0.857. Attention visualizations of the model explain complex mechanisms that dynamically weigh different information modalities based on case severity. Furthermore, a systematic feature importance analysis identifies key predictive factors, particularly hematological parameters and cardiac markers, offering valuable insights for clinical practice. Our study positions APSevLM as an accurate predictive model and highlights potential biomarkers for the early diagnosis of severe AP.