Comparative Study of the Prognostic Efficiency between Ranson's Criteria and Modified Computed Tomography Severity...

Acute pancreatitis (AP) ranges from mild disease to severe forms associated with organ failure and significant mortality. Early assessment of disease severity is important for timely management and improved outcomes. Ranson's criteria is a traditional clinical scoring system, whereas the modified computed tomography severity index (MCTSI) is a radiological scoring system used to assess disease severity. This study compared the prognostic performance of these two scoring systems in patients with AP.

A hospital-based cross-sectional observational study was conducted from 2020 to 2021 at a tertiary care center in Chengalpattu, Tamil Nadu, India. A total of 122 adults aged 25-70 years with confirmed AP were included. Disease severity was assessed using Ranson's criteria at admission and 48 h and MCTSI based on contrast-enhanced computed tomography findings. Outcomes evaluated included organ failure, mortality, and length of hospital stay. Receiver operating characteristic curve analysis was performed.

The mean age was 41.8 ± 8.9 years, with male predominance (98.4%), and alcohol was the most common etiology (75.4%). According to the MCTSI classification, 26.2% had mild, 53.3% moderate, and 20.5% severe pancreatitis. Organ failure occurred in 29.5%, and mortality was 5.7%. Length of hospital stay increased significantly with disease severity (P < 0.001). MCTSI showed higher predictive accuracy with area under the curve = 0.93 compared with 0.81 for Ranson's criteria.

MCTSI demonstrated superior prognostic performance compared with Ranson's criteria in predicting severity and clinical outcomes in AP and may be useful for early risk stratification.