Severity Assessment of Acute Pancreatitis Using the Modified Computed Tomography Severity Index and Revised Atlanta Classification: Correlation with Bedside Index for Severity in Acute Pancreatitis Clinical Scoring

BACKGROUND: Acute pancreatitis (AP) is a pancreatic inflammatory condition characterised by a varied clinical course, ranging from mild self-limiting episodes to severe disorder associated with significant morbidity and mortality. Proper severity evaluation is crucial for prompt intervention and enhanced outcomes. AIMS: This study assesses the efficacy of the Modified Computed Tomography (CT) Severity Index (MCTSI) and Revised Atlanta Classification (RAC) in conjunction with the Bedside Index for Severity in AP (BISAP) for evaluating disease severity and forecasting clinical outcomes. METHODS: A cross-sectional observational study was performed at SRM Medical College Hospital involving 45 patients with AP. BISAP was carried out following 24 h of admission, whereas MCTSI was evaluated using contrast-enhanced CT. Severity was categorised utilising RAC, and clinical-radiological connections were examined. RESULTS: RAC indicated that 40%, 46.7% and 11.1% of patients encountered mild, moderately severe and severe AP, respectively. The mean BISAP and MCTSI scores were 1.8 ± 0.9 and 6.1 ± 2.3, respectively. Despite individual variations in raw scores, correlation analysis employing Spearman's rank test revealed a statistically significant moderate positive correlation between BISAP and MCTSI (rho = 0.563, P < 0.01). This suggests that as BISAP ratings escalated, MCTSI levels similarly increased, demonstrating a correlation between the two scoring systems in assessing illness severity. CONCLUSION: BISAP and MCTSI provide combined advantages in predicting the severity of AP. The RAC continues to be a reliable classification system. The integration of clinical and imaging methods improves early risk assessment and leads to appropriate care.