A prospective comparative study of MEWS and BISAP scores with CTSI in predicting severity of Acute pancreatitis

Authors

  • Arwin Das Prabhu Junior Resident, Department of General Surgery, Government Medical College, Kozhikode, Kerala, India
  • Manjush Edathikudi Associate Professor, Department of General Surgery, Government Medical College, Kozhikode, Kerala, India
  • K C Soman Professor, Department of General Surgery, Government Medical College, Kozhikode, Kerala, India

Keywords:

Acute pancreatitis, Bedside index of severity of acute pancreatitis, Computed Tomography Severity Index.

Abstract

Aim: To evaluate the accuracy of MEWS and BISAP scoring systems to predict the severity of Acute Pancreatitis in comparison to CT Severity Index (CTSI) in patients with acute pancreatitis (new & known cases). Method: A prospective cross-sectional study conducted on 111 Patients with clinical/laboratory/ultrasonography diagnosed acute pancreatitis (new & known cases) who are willing to undergo Contrast enhanced computed tomography. BISAP and CTSI scores were calculated at 6, 24 and 48 hours after admission. Contrast enhanced CT scan was done at 72 hours and calculated CTSI score. Predictive accuracy of the MEWS, BISAP and CTSI was measured by the area under the receiver-operating curve (AUC). Results: Most of the pancreatitis occurs in the age group 20-40. Among the 111 patients studied, majority (N=99, 89%) were males. The mean age of presentation was 39.7+13.5. Alcohol (N=63, 57%) followed by Gall stones (N=31, 28%) was the most common etiology. BISAP score at presentation was compared against CTSI (P=0.001) and 95% confidence interval between 0.651 and 0.963. BISAP score had a sensitivity of 75% and specificity of 78.8%, Positive PPV of 50% and NPV of 89.69%. MEWS at 6, 24 and 48 hours was plotted against CT severity index, P= 0.005, 95% Confidence interval lied between 0.604 and 0.896, 0.602 and 0.902 and 0.603 and 0.899 respectively. MEWS had a sensitivity of 75% and specificity of 64.6%, NPV and PPV were 92% and 26% respectively. Conclusion: Low MEWS and BISAP scores have high negative predictive value in predicting severe acute pancreatitis. Thus it can be reliably used in early prognostication of severity in acute pancreatitis in our setting.

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Published

2021-09-17

How to Cite

Arwin Das Prabhu, Manjush Edathikudi, & K C Soman. (2021). A prospective comparative study of MEWS and BISAP scores with CTSI in predicting severity of Acute pancreatitis. International Journal of Health and Clinical Research, 4(16), 147–151. Retrieved from https://www.ijhcr.com/index.php/ijhcr/article/view/2621