A Study to Assess the Pancreatitis Three-Factor Scoring System in Comparison With Computed Tomography (CT) Severity Index Scoring in Predicting the Severity of Acute Pancreatitis.

BACKGROUND

Acute pancreatitis is a common gastrointestinal emergency with potentially severe forms requiring early risk prediction for effective management. This study evaluated the diagnostic performance of the PANC3 scoring system in predicting severity and compared it with the CT Severity Index (CTSI).

METHODS

A prospective, non-randomised study was conducted at a tertiary care centre in Chennai from January 2020 to November 2021, involving 60 patients diagnosed with acute pancreatitis within 48 hours of symptom onset. PANC3 scoring was based on haematocrit, BMI, and pleural effusion. All patients underwent contrast-enhanced CT at 48 hours to determine the CTSI. Statistical analysis included chi-square testing and the evaluation of the receiver operating characteristic (ROC) curve.

RESULTS

Among 60 patients, 25 (41.7%) were classified as severe acute pancreatitis (SAP) by the CTSI. Of these, 10 (16.7%) had a positive PANC3 score (score = 3), all of whom (100%) had severe disease, yielding a specificity and a positive predictive value of 100% and a sensitivity of 40%. The overall diagnostic accuracy of the PANC3 score was 75% (AUC = 0.700, p = 0.009). BMI >30 kg/m² (41; 68.3%) and pleural effusion (30; 50%) were significantly associated with severity, while elevated haematocrit >44% (22; 36.6%) was not.

CONCLUSION

PANC3 demonstrates high specificity and positive predictive value for early identification of SAP, offering a simple and cost-effective risk stratification tool when used alongside established scoring systems.