Abstract:
Objectives: To determine the diagnostic accuracy of the Modified CT Severity Index in assessing the severity of acute
pancreatitis, using the APACHE II score as the gold standard.
Study Design and Setting: This was a descriptive cross-sectional study conducted at Liaquat National Hospital, Karachi,
over a period of six months from May 1, 2023, to November 30, 2023.
Methodology: A total of 68 patients aged 18–75 years, clinically and ultrasonographically diagnosed with acute pancreatitis,
were included through non-probability consecutive sampling. Patients with incomplete APACHE II data or a history of
trauma were excluded. MCTSI scores were calculated from contrast-enhanced CT scans and compared with APACHE II
scores. Diagnostic accuracy measures, including sensitivity, specificity, positive predictive value (PPV), negative predictive
value (NPV), and overall accuracy, were calculated. Data were stratified by age and gender.
Results: MCTSI demonstrated a sensitivity and specificity of 75% each when compared with APACHE II scores. In patients
aged <45 years, sensitivity and specificity were 88.8% and 70.3%, respectively. In those =45 years, sensitivity was 57%
and specificity was 84%. Among females, sensitivity reached 100% with a specificity of 79%, while in males, sensitivity
and specificity were 69.2% and 75%, respectively. The overall diagnostic accuracy of MCTSI was 76.4%.
Conclusions: MCTSI offers a reliable and practical alternative to APACHE II for early assessment of severity in acute
pancreatitis, especially when rapid imaging is available. Its simplicity and reasonable accuracy make it a valuable tool in
routine clinical practice.
