Kali Chandra Shekar, Kadali Vinoda, Chakra G Sandeep, Suvvari Tarun Kumar, Karangula Sindhuja, Kata Srinivasa Rajasekhar, Yedida Nagateja, Muppavarapu Ramya Sree, Gundraju Sumanth
General Medicine, Government Medical College, Rajamahendravaram, IND.
General Medicine, Rangaraya Medical College, Kakinada, IND.
Cureus. 2025 Jul 14;17(7):e87913. doi: 10.7759/cureus.87913. eCollection 2025 Jul.
Introduction Acute pancreatitis (AP) is a potentially life-threatening inflammatory disorder of the pancreas with a wide spectrum of clinical manifestations. Early identification of disease severity is critical for guiding management and improving outcomes. Prognostic scoring systems such as the Bedside Index for Severity in Acute Pancreatitis (BISAP) and the CT severity index (CTSI) are commonly used to predict disease progression and complications. This study aimed to evaluate the clinical profile of patients with AP and assess the utility of BISAP and CTSI scores in predicting clinical outcomes. Methods This cross-sectional study was conducted in the Department of General Medicine from April 2025 to May 2025 (two months). Patients diagnosed with AP were enrolled based on clinical, biochemical, and radiological criteria. Detailed clinical histories, physical examinations, and laboratory investigations were recorded. BISAP scores were calculated at admission, and contrast-enhanced CT scans were performed on day four or five of illness to determine CTSI scores. Patients were monitored throughout their hospital stay, and outcomes were assessed at discharge. Results Fifty patients with AP were enrolled. The most common etiology was alcohol consumption (74%). A BISAP score ≥3 was observed in 6% of patients and was significantly associated with mortality (p=0.039). The CTSI indicated severe AP in 12% of patients and was significantly associated with both mortality (p=0.002) and complications (p=0.002). The BISAP score demonstrated excellent predictive ability for mortality [area under the curve (AUC)=0.934], while CTSI provided superior sensitivity and predictive accuracy for complications (AUC=0.658). A moderate positive correlation was observed between BISAP and CTSI (r=0.45, p=0.019). Conclusions Both BISAP and CTSI are effective predictors of outcomes in AP. BISAP is a valuable bedside tool for early mortality risk stratification, particularly in resource-limited settings, while CTSI remains indispensable for assessing complications and guiding interventional strategies. The combined use of both scoring systems can enhance clinical decision-making and optimize patient management.
引言 急性胰腺炎（AP）是一种潜在危及生命的胰腺炎症性疾病，临床表现多样。早期识别疾病严重程度对于指导治疗和改善预后至关重要。诸如急性胰腺炎床边严重程度指数（BISAP）和CT严重程度指数（CTSI）等预后评分系统常用于预测疾病进展和并发症。本研究旨在评估AP患者的临床特征，并评估BISAP和CTSI评分在预测临床结局中的效用。方法 本横断面研究于2025年4月至2025年5月（两个月）在普通内科进行。根据临床、生化和放射学标准纳入诊断为AP的患者。记录详细的临床病史、体格检查和实验室检查结果。入院时计算BISAP评分，并在发病后第4天或第5天进行增强CT扫描以确定CTSI评分。在患者住院期间进行全程监测，并在出院时评估结局。结果 纳入50例AP患者。最常见的病因是饮酒（74%）。6%的患者BISAP评分≥3，且与死亡率显著相关（p=0.039）。CTSI显示12%的患者为重症AP，且与死亡率（p=0.002）和并发症（p=0.002）均显著相关。BISAP评分对死亡率具有出色的预测能力[曲线下面积（AUC）=0.934]，而CTSI对并发症具有更高的敏感性和预测准确性（AUC=0.658）。BISAP和CTSI之间观察到中度正相关（r=0.45，p=0.019）。结论 BISAP和CTSI都是AP结局的有效预测指标。BISAP是早期死亡风险分层的有价值床边工具，特别是在资源有限的环境中，而CTSI对于评估并发症和指导干预策略仍然不可或缺。两种评分系统联合使用可增强临床决策并优化患者管理。
