COMPARATIVE EVALUATION OF THE DIAGNOSTIC ACCURACY OF MODIFIED CT SEVERITY INDEX FOR PREDICTION OF ACUTE PANCREATITIS SEVERITY: A CLINICAL RADIOGRAPHIC ASSESSMENT

Abstract

Objective: The present study was conducted to comparatively assess the clinical scoring of Bedside Index for Severity in Acute Pancreatitis (BISAP) to radiographic scoring system Modified Computed Tomography Severity Index (MCTSI) for predicting the severity and organ failure in subjects with acute pancreatitis with the evaluation of the diagnostic accuracy of MCTSI. Methods: The present study included subjects from all age groups having at least 2 features of sonographic findings of acute pancreatitis, pain in epigastrium radiating to back, and/or serum amylase/lipase 3 folds higher than the normal limit. Radiological MCTSI and clinically BISAP scoring were done and compared to assess the diagnostic accuracy of MCTSI in accurately predicting the severity and organ failure in subjects with acute pancreatitis. Results: No organ failure was seen in 54% (n=27) study subjects wherein subjects with MCTSI <4 the sensitivity, specificity, and p-value was 96, 40, and 0.000 respectively, whereas, in subjects with BISAP <2, sensitivity, specificity, and p-value was 100, 30, and 0.000 respectively. Transient organ failure was seen in 28% (n=14) subjects wherein subjects with MCTSI score >4 (4-6) sensitivity, specificity, and p-value was 95, 30, and 0.01 respectively, whereas, for BISAP score of >2 sensitivity, specificity, and p-value were 83, 46, and 0.02 respectively. These results showed statistical significance. Persistent organ failure was seen in 9 (18%) study subjects where for MCTSI score ≥8 (8-10) sensitivity, specificity, and p-value respectively were 100, 78, and 0.000, whereas, for BISAP score of >2, these values respectively were 74, 85, and 0.000 Conclusion: The present study concludes that MCTSI accurately predicts the severity and organ failure in subjects with acute pancreatitis and is a simple scoring system.