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New Indian Journal of Surgery

Volume  10, Issue 6, November-December 2019, Pages 559-566
 

Original Article

Comparison of CTSI and BISAP Scoring in the Assessment of Severity and Mortality in Cases of Acute Pancreatitis

Abraham Benjamin Muthunayagam1, Chitra R2, Muruganand Myilsamy3, Vinoth4

1,2,3,4Assistant Professor, Department of General Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu 641004, India

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10619.1

Abstract

Background: Acute pancreatitis is a disease where earlier initiation of treatment in case of complication gives a better prognosis to the patient. It has been firmly established that the BISAP scoring system is superior to the other clinical scoring system and the superiority of the CTSI scoring has been established for almost a decade. Yet, there are very few studies that directly compare these two scores directly. Hence, such a study is of utmost importance at this time as it can decrease the financial burden for the patient as well as provide a simple scoring system for the surgeon. This study compares CTSI and BISAP scoring in the assessment of severity and mortality of acute pancreatitis, and assess the validity, the specificity and the sensitivity of both the scoring systems. Methodology: In 35 patients diagnosed with acute pancreatitis, the BISAP score was calculated, and after 48 hours of onset of symptoms, CTSI scoring done. The data was then analyzed with STATA statistical software. Results: BISAP score showed a sensitivity of 100% and specificity of 36.8% in establishing the mortality of acute pancreatitis with cut-off value taken as > 1. If the cut-off value is taken as > 2, the sensitivity became 56.3% and specificity became 79%. CTSI score showed a sensitivity of 64% and specificity of 100% in establishing the onset of complications in cases of acute pancreatitis. Conclusion: Our study showed that BISAP score is comparable to CTSI in predicting the prognosis and mortality of cases of acute pancreatitis but does not compare with CTSI in establishing degree of necrosis. Hence, BISAP score is a simple, cost-effective scoring system that can be implemented in tertiary and even most primary healthcare centres.

Keywords: BISAP; CTSI; Acute pancreatitis; Predicting morbidity; Complications of acute pancreatitis; Pancreatic necrosis BISAP; CTSI; Acute pancreatitis; Predicting morbidity; Complications of acute pancreatitis; Pancreatic necrosis.


Corresponding Author : Chitra R