Background: Background: Acute pancreatitis is a common gastrointestinal emergency that can range in severity from mild inflammation that goes away on its own to a serious illness that causes organ failure, pancreatic necrosis, and death. Appropriate triage and prompt response depend on early detection of patients at risk of unfavorable outcomes. While the Computed Tomography Severity Index (CTSI) offers an anatomical evaluation of illness severity, serum procalcitonin (PCT) has become a potential biomarker of systemic inflammation and infection. In patients with acute pancreatitis, a comparative analysis of various modalities may increase the accuracy of the prognosis.

Objective: To evaluate the severity of the disease and forecast clinical outcomes in individuals with acute pancreatitis by comparing blood procalcitonin levels with the CT Severity Index.

Methods: Over the course of a year, 45 consecutive patients who were diagnosed with acute pancreatitis at the Department of General Surgery, Assam Medical College and Hospital, Dibrugarh, were included in this hospital-based prospective observational study. On admission, serum procalcitonin levels were assessed, and 72 hours later, CTSI was assessed using contrast-enhanced computed tomography. The CTSI, BISAP, Ranson’s score, and Modified Marshall score were used to assess the severity of the disease. Clinical outcomes were documented, including length of stay in the intensive care unit (ICU), overall hospital stay, complications, and mortality. The predictive performance of serum procalcitonin and CTSI was assessed using correlation analysis and receiver operating characteristic (ROC) curve analysis.

Results: A total of 45 patients with acute pancreatitis were included in the study. The majority of patients belonged to the 31–50-year age group, with a male predominance (75.6%). Alcohol consumption was the most common etiological factor (60%). Serum procalcitonin demonstrated significant positive correlations with CT Severity Index (r = 0.68, p < 0.001), ICU stay (r = 0.61, p < 0.001), hospital stay (r = 0.54, p = 0.001), and mortality (r = 0.72, p < 0.001). Higher CT Severity Index scores were associated with prolonged hospitalization and greater disease severity. These findings indicate that both serum procalcitonin and CT Severity Index are valuable predictors of disease severity and clinical outcomes in acute pancreatitis.

Conclusion: While the CT Severity Index offers useful anatomical information on pancreatic necrosis and local sequelae, serum procalcitonin is a trustworthy early biomarker for predicting disease severity and unfavorable outcomes in acute pancreatitis. When serum procalcitonin and CT Severity Index are used together, risk stratification is better than when either modality is used alone. This allows for early clinical decision-making and better patient care.

KEYWORDS: Acute Pancreatitis, Procalcitonin, CT Severity Index, Computed Tomography, Disease Severity; Prognosis, Pancreatic Necrosis.