Correlation of Modified CT Severity Index (MCTSI) and serum lipase levels in assessing acute pancreatitis severity: a prospective cross-sectional study.

BACKGROUND

Acute pancreatitis is a common gastrointestinal emergency requiring rapid assessment of severity. This study aimed to evaluate the association between Modified Computed Tomography Severity Index (MCTSI) and serum lipase levels, exploring whether lipase may serve as a surrogate marker of severity in settings where computed tomography (CT) is not readily available.

METHOD: This prospective observational cohort study included 63 patients with acute pancreatitis who underwent contrast-enhanced CT and serum lipase testing between March 2024 and February 2025 at Bir Hospital. Patients were followed for clinical findings, length of hospitalization, ICU admission, and in-hospital mortality. MCTSI was calculated by two radiologists independently.

RESULT: Moderately severe acute pancreatitis (MCTSI 4-6) was observed in 41.3% of patients. Mean serum lipase was 1789.9 U/L, with a strong positive association with MCTSI (rho = 0.793, P < 0.0001). Patients with severe MCTSI (scores 8-10) had significantly higher lipase levels (3204 ± 459 U/L) and longer hospital stays. Lipase ≥2160 U/L predicted severe acute pancreatitis with 95.2% sensitivity and 83.3% specificity (area under the curve = 0.946).

CONCLUSION

Serum lipase levels correlate significantly with MCTSI-based severity and hospital outcomes in acute pancreatitis. Lipase may serve as a useful surrogate marker in settings without CT access. Further multicenter studies are warranted.