Diagnostic Accuracy of Bedside Index for Severity in Acute Pancreatitis and Modified Computed Tomography Severity Index in Determining the Severity of Acute Pancreatitis using Revised Atlanta Classification as the Gold Standard

Abstract

Objective: To determine the diagnostic accuracy of modified computed tomography severity index (CTSI) and Bedside index for severity in acute pancreatitis (BISAP) scoring system in predicting severity in acute pancreatitis, keeping the Revised Atlanta Classification (RAC) as the gold standard.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, Pakistan from Jan to Jul 2022.

Methodology: This study was conducted on 100 patients with acute pancreatitis, both genders and ages. Patients with chronic pancreatitis, pancreatic calcifications, dilated pancreatic duct, areas of atrophy and pseudocysts were excluded. Detailed history and physical examination, and laboratory investigations were performed. Modified CTSI, BISAP and RAC were calculated. RAC was used as the gold standard. Sensitivity, specificity and other diagnostic parameters were calculated using R programme.

Results: The mean age was 42.42±18.07 years. The males were 53%, and the females were 47%. CTSI was sensitive at 100%, specific at 58.43%, and overall diagnostic accuracy at 63%. BISAP was sensitive at 100%, specific at 68.54%, and overall diagnostic accuracy at 72%.

Conclusion: BISAP and modified CTSI can assess severe acute pancreatitis (SAP) at primary and secondary care levels, enabling early triage and referral to higher centers.