Correlation of Modified CT Severity Index with Complications of Acute Pancreatitis

Abstract

Objective: To determine the correlation between the Modified CT Severity Index (MCTSI) and complications of acute pancreatitis and to evaluate its predictive ability for clinical outcomes.

Methodology: An analytical cross-sectional study was conducted at Pakistan Aeronautical Complex (PAC) Hospital, Kamra, and Pakistan Air Force (PAF) Hospital, Islamabad, between October 2024 and September 2025. Non-probability consecutive sampling of patients with acute pancreatitis yielded a sample of 50. All patients underwent a contrast-enhanced computed tomography scan of the abdomen (CECT) and were classified by MCTSI. An assessment for local and systemic complications, ICU admission, requirement for intervention, and length of hospital stay were all assessed of each patient. Fisher’s exact test, Spearman correlation coefficient, and ROC curve analysis were used to analyze statistical data.

Results: The patient’s mean age was 35.7±10.5 years. The percentage of patients receiving admission to the ICU increased progressively by severity of acute pancreatitis: 33% for mild severity and 100% for severe cases. Local complications were observed in 24% (pseudocyst) and 2.6% (abscess) of patients and were predominantly identified among grade 3 and 4 MCTSI. Systemic complications occurred in 6% of patients and were significantly associated with severe acute pancreatitis (p<0.001). MCTSI was found to have a strong correlation with the total number of complications (r=0.68, p=0.001). ROC analysis showed a good predictive accuracy of the MCTSI for complications (AUC 0.83, 95% CI 0.72-0.94) with sensitivity of 81% and specificity of 78% at MCTSI cut-off value of ≥6.

Conclusion: MCTSI is associated with complications of acute pancreatitis and provides a reliable prediction of adverse clinical outcomes, supporting its use in early identification of risk and clinical decision-making.

Keywords: Intensive Care Units, Length of Stay, Pancreatitis Acute Necrotizing, Prognosis, ROC Curve, Severity of Illness Index, Tomography, X-Ray Computed.