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. 2025 Jul 14;17(7):e87913.
doi: 10.7759/cureus.87913. eCollection 2025 Jul.

Understanding Etiopathogenesis and Clinical Outcomes in Acute Pancreatitis: An Experience From a Tertiary Care Teaching Hospital in Andhra Pradesh

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Understanding Etiopathogenesis and Clinical Outcomes in Acute Pancreatitis: An Experience From a Tertiary Care Teaching Hospital in Andhra Pradesh

Chandra Shekar Kali et al. Cureus. .

Abstract

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.

Keywords: acute pancreatitis; bisap score; clinical outcome; clinical study; ct severity index; prognostic scoring.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, RMC issued approval IEC/RMC/2025/1405. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Correlation Between BISAP score and CTSI (Pearson r=0.45, p=0.019)
BISAP: Bedside Index for Severity in Acute Pancreatitis; CTSI: CT severity index

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