To investigate the application value of modified CT severity index (MCTSI) and detection of serum inflammatory factors in the prediction of pancreatic infection and prognosis evaluation of severe acute pancreatitis (SAP).

A total of 110 patients with SAP in Weihai Hospital of Traditional Chinese Medicine were enrolled in this study between May 2020 and December 2022. Patients were enrolled at the starting point and observed for 28 days They were divided into infected group (n=21) and uninfected group (n=89) according to the presence or absence of secondary pancreatic infection. Based on the prognosis, the patients were divided into survival group (n=93) and death group (n=17). All patients were subjected to enhanced CT examination and detection of serum inflammatory factors on the first day after admission. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of MCTSI combined with serum inflammatory factors (IL-6/8/10) for secondary pancreatic infection and prognosis.

Serum IL-6 and IL-8 levels in the infected group were higher than those in the uninfected group, and IL-10 level were lower than that in the uninfected group (P<0.05). The MCTSI showed no significant difference between the infected group and the uninfected group at admission (P>0.05). The area under the ROC curve of joint prediction of serum IL-6, IL-8 and IL-10 for pancreatic infection in patients with SAP was 0.850, greater than that of each index single prediction (0.750, 0.736, 0.728) (P<0.05). Serum IL-6 and IL-8 levels in the death group at admission were lower than those in the survival group, and IL-10 level was higher than that in the survival group (P<0.05). The death group had higher MCTSI score than the survival group at admission (P<0.05). The area under the ROC curve of MCTSI combined with serum inflammatory factors for prognosis of patients with SAP was 0.872, greater than that of IL-6, IL-8, IL-10 or MCTSI score alone (0.687, 0.685, 0.667, 0.773) (P<0.05).

The incresde of serum IL-6 and IL-8 and the decrease of IL-10 can be used as sensitive indicators of pancreatic infection in patients with SAP. Although the MCTSI score cannot effectively predict pancreatic infection, it can be used for evaluating prognosis when combined with serum inflammatory factors.