Background: Acute pancreatitis is a severe inflammatory condition with a varied clinical course. Early prediction of disease severity is crucial to guide management and improve outcomes. This study aimed to compare the predictive accuracy of Ranson's criteria and Mortele’s modified CT severity index (MDCTSI) in assessing the severity and prognosis of acute pancreatitis.

Methods: A retrospective study was conducted on 120 patients with acute pancreatitis admitted to the Department of General Surgery in hospitals associated to Bangalore Medical College and Research Institute from September 2021 to August 2022. Patients were evaluated based on clinical findings, laboratory results, and CT scans. Outcomes were assessed using Ranson's score and MDCTSI.

Results: Both scoring systems accurately predicted the severity of the disease, complications, and mortality. All deaths occurred in patients with a Ranson's score and MDCTSI of >3 and >6, respectively. Patients with a Ranson’s score of >3 and MDCTSI of >6 had a higher rate of complications (59% and 71%, respectively) and ICU admission (100% and 80%, respectively).

Conclusion: Ranson's scoring system and Mortele’s MDCTSI are effective tools in predicting the clinical course, complications, and mortality in acute pancreatitis. These findings underline the utility of these scoring systems in facilitating patient management and potentially reducing morbidity and mortality.