SEVERITY OF ACUTE PANCREATITIS: CORRELATING BISAP SCORE, POCUS, AND CT FINDINGS IN A TERTIARY EMERGENCY SETTING

Abstract

Acute pancreatitis (AP) presents with a wide spectrum of severity. Stratification must be done accurately and early in order to maximize management and enhance results. The objective of this investigation was to assess the correlation between the Bedside Index for Severity in Acute Pancreatitis (BISAP) score, point-of-care ultrasound (POCUS), and contrast-enhanced CT (CECT) findings in assessing the extent of AP and envisaging short-term clinical outcomes. A research of prospective research study was carried out on 100 patients presenting with AP over one year. BISAP scores were considered within 24 hours of admission. POCUS was performed on all patients, and CECT was performed when indicated. Associations among BISAP scores, ultrasound findings, CT severity index (CTSI), and six-week outcomes were analyzed using appropriate statistical tests. The majority (64%) of patients were aged between 30–60 years; 67% were female. Gallstones were the most common etiology (64%), followed by idiopathic causes (28%). BISAP score was 0–2 in 84% and 3–5 in 16%. All seven deaths occurred in the BISAP ≥3 group (p < 0.001). POCUS revealed pleural effusion in 30% and peripancreatic fluid in 45% of patients. Pleural effusion showed a significant implication with higher BISAP scores (p = 0.012), and the presence of both pleural effusion and fluid collections was also significantly related to severity (p = 0.039). CT was performed in 50% of patients; 46% had necrotizing pancreatitis. However, no statistically significant correlation was observed between BISAP and CTSI (p = 0.137). BISAP score calculated within 24 hours, when used in conjunction with early POCUS, offers a practical and reliable method for early risk stratification in AP. In resource-limited settings, this combined approach offers a fast, cost-effective, and evidence-based alternative to CT-based assessments.