Study of various scoring systems on admission for the development of intra and peripancreatic fluid collection and necrosis in acute pancreatitis

Background: Acute pancreatitis (AP) is a sudden inflammatory condition of the pancreas with variable clinical outcomes ranging from mild discomfort to severe life-threatening complications, including intra- and peripancreatic fluid collections and necrosis. Accurate early prediction of disease severity is essential for effective management. Aims and Objective: To evaluate and compare the efficacy of bedside index for severity in acute pancreatitis (BISAP), Acute Physiology and Chronic Health Evaluation II (APACHE II), and modified-computed tomography severity index (MCTSI) scoring systems in predicting the development of intra- and peripancreatic fluid collection and necrosis in patients with AP. Materials and Methods: This prospective observational study was conducted at Maharani Laxmi Bai Medical College, Jhansi, enrolling 125 patients with AP from March 2024 to February 2025. Each patient’s severity was assessed using BISAP, APACHE II, and MCTSI scores at admission. Correlations were analyzed between these scores and clinical outcomes, including fluid collection, necrosis, and complications. Results: Most of the patients were male (88%), with the highest age group >60 years (35.2%). BISAP and APACHE II scores showed increasing trends with severity. MCTSI score was strongly associated with radiological findings of necrosis (45.83%) and fluid collection (62.5%). Comparative analysis revealed no statistically significant difference between the scoring systems in predicting pancreatic necrosis or fluid collection (P>0.05), although each showed reliable predictive capability. Conclusion: BISAP, APACHE II, and MCTSI scores are comparably effective in predicting severity and complications in AP. An integrated approach using clinical, physiological, and radiological parameters is recommended for optimal risk stratification.