Background and Objectives: Acute pancreatitis severity stratification remains a clinical challenge, with contrast-enhanced computed tomography (CECT) typically deferred until 48 to 72 hours after symptom onset. This study aimed to evaluate and correlate the biochemical markers of serum lipase and amylase with radiological severity, as assessed by the Modified Computed Tomography Severity Index (MCTSI). A secondary objective was to determine the association of these parameters with patient morbidity and mortality.

Materials and Methods: A cross-sectional observational study was conducted at KHPIMS, Gadag, over a two-year period (March 2024 to February 2026). The study included 146 patients between 18 and 60 years of age diagnosed with acute pancreatitis. Admission serum amylase and lipase levels were measured and compared against MCTSI scores obtained via CECT. Patients were categorized by MCTSI into mild (score 0-2), moderate (score 4-6), and severe (score 8-10) groups.

Results: The study population exhibited a mean age of 37.1 years, with a strong male predominance of 93.8%, indicating alcohol consumption as the primary etiological driver. Based on MCTSI scoring, 61.0% of cases were mild, 32.9% were moderate, and 6.1% were severe. A statistically significant positive correlation was observed between MCTSI scores and both serum amylase (r = 0.362, p < 0.001) and serum lipase (r = 0.345, p < 0.001). Receiver Operating Characteristic (ROC) curve analysis established that a serum amylase level > 343 U/L yielded a 70.00% sensitivity and 70.20% specificity for predicting moderate-to-severe disease. A serum lipase level > 548 U/L yielded a 66.00% sensitivity and 70.20% specificity. Local complications were identified in 24.0% of patients. The overall mortality rate was 1.4% (2 deaths), both occurring in patients with severe necrotizing pancreatitis complicated by Multiple Organ Dysfunction Syndrome (MODS).