Etiological Profile and Clinical Predictors of Severity in Acute Pancreatitis: A Comparative Evaluation Using BISAP and Ranson Scores

Abstract

Background:
Acute pancreatitis (AP) is a potentially life-threatening inflammatory condition of the pancreas with varied etiologies and clinical presentations. Accurate early prediction of disease severity is crucial for effective management and triage. This study aimed to assess the etiological profile of AP and evaluate the predictive performance of BISAP and Ranson scoring systems in a tertiary care center.
Methods:
This prospective observational study included 50 patients diagnosed with acute pancreatitis between January 2021 and December 2022. Data were collected on demographics, clinical presentation, laboratory parameters, and outcomes. Etiology was documented, and severity was assessed using BISAP (within 24 hours) and Ranson (over 48 hours) scores. Statistical analysis included sensitivity, specificity, and diagnostic accuracy calculations, using Ranson score as the reference standard.
Results:
The most common etiology was alcohol-related (92%), with a predominance of young males (mean age 34.3 ± 8.7 years; 94% male). Abdominal pain and vomiting were universal presenting symptoms. BISAP score demonstrated a sensitivity of 87.5%, specificity of 100%,PPV of 100%, and NPV of 97.67% in predicting severe AP, with an overall diagnostic accuracy of 98%. Both BISAP and Ranson scores showed a significant association with disease severity and short-term clinical outcomes.
Conclusion:
In the Indian clinical context, alcohol remains the predominant cause of AP. BISAP is a reliable and efficient early predictor of disease severity and can serve as a valuable triage tool in emergency settings, offering comparable accuracy to Ranson score with better feasibility.