DIAGNOSTIC ACCURACY OF MODIFIED CT SEVERITY INDEX FOR PREDICTION OF ACUTE PANCREATITIS SEVERITY
Keywords:
organ failure, modified computed tomography severity index, acute pancreatitisAbstract
Background: Severe pancreatitis patients have an increased risk of developing systemic inflammatory responses, cardiovascular failure, gastrointestinal bleeding, respiratory failure, renal failure-related organ failure, and DIC (disseminated intravascular coagulation).
Aim: to evaluate the diagnostic accuracy of the radiographic scoring system. To compare the clinical scoring of Bedside Index for Severity in Acute Pancreatitis (BISAP) with the radiographic scoring system, Modified Computed Tomography Severity Index (MCTSI)
Methods: all individuals had non-contrast and contrast-enhanced MDCT. Utilizing scans of 5 mm thickness reconstructed at 0.625 to 1.5 mm starting from upper diaphragm boundary to below pubis symphysis, MDCT was performed utilising same radiography conditions and equipment.
BISAP scores were computed using a combination of biochemical parameters and clinical conditions. The scoring criteria consisted of five points, each reflecting a condition such as the presence of a pleural effusion, age greater than 60, systemic inflammatory response syndrome, altered mental status, or blood urea nitrogen level greater than 25 mg/dl, and all within 24 hours of presentation
Result: Of the research individuals, 54% (n=27) did not experience any organ failure. Those with an MCTSI <4 had sensitivity, specificity, and p-values of 96, 40, and 0.000, respectively; those with a BISAP <2 had sensitivity, specificity, and p-values of 100, 30, and 0.000, respectively. In 28% of the individuals (n=14), transient organ failure was seen. The sensitivity, specificity, and p-value for subjects with an MCTSI score >4 (4-6) were 95, 30, and 0.01 respectively, whereas the corresponding values for subjects with a BISAP score of >2 were 83, 46, and 0.02 respectively.
Conclusion: The current study suggests that the MCTSI is a straightforward scoring system that reliably predicts the severity and organ failure in people with acute pancreatitis.
