Comparative Evaluation of BISAP Score and CT Severity Index in Predicting Severity and Outcome of Acute Pancreatitis

Background: Acute pancreatitis is a frequently encountered gastrointestinal emergency. Early recognition of potentially severe acute pancreatitis is critical and needs to be done to allow for prompt treatment and minimise morbidity and mortality. Several scoring systems, such as the Computed Tomography Severity Index (CTSI) and the Bedside Index for Severity in Acute Pancreatitis (BISAP) score, have been developed to predict clinical outcomes and prognosticate the severity of acute pancreatitis. The objective is to investigate the predictive power of the CT Severity Index and BISAP score for the clinical outcomes, complications, and severity of acute pancreatitis in patients. Material and Methods: This comparative observational study was done in Department of General Surgery for a period of one year. The study comprised sixty individuals with clinical characteristics, radiological data, and serum amylase/lipase suggestive of acute pancreatitis. BISAP assessment was completed within 24 hours of admission, and a contrast-enhanced computed tomography (CECT) was used to determine the CT Severity Index 72 hours after the onset of symptoms. The following were noted: severity grading, local complications, organ failure, hospital stay and mortality. Both scoring systems were evaluated for sensitivity, specificity, positive and negative predictive values. The p values are taken to be statistically significant when they are below 0.05. Results: Among the 60 patients studied, 42 (70.0%) were males and 18 (30.0%) were females. Alcohol was the most common etiological factor observed in 34 (56.7%) patients, followed by gallstone disease in 18 (30.0%) cases. Severe acute pancreatitis was identified in 16 (26.7%) patients based on clinical outcome assessment. BISAP score ≥3 was observed in 15 (25.0%) patients, while CTSI score ≥7 was identified in 17 (28.3%) patients. When it came to predicting severe pancreatitis, BISAP exhibited 87.5% sensitivity and 90.9% specificity, while CTSI showed 93.7% sensitivity and 88.6% specificity. CTSI demonstrated slightly higher sensitivity for detecting local complications, while BISAP was more convenient for early bedside assessment. Conclusion: BISAP provides rapid and reliable early prognostic assessment, whereas CTSI offers better evaluation of local pancreatic complications. Combined use of both scoring systems may improve risk stratification and facilitate timely management of patients with acute pancreatitis.

Keywords: Acute pancreatitis; BISAP score; Computed tomography severity index; Organ failure; Pancreatic necrosis; Prognosis; Severity assessment.