Background: To investigate the predictive value of Modified CT Severity Index (MCTSI) score combined with clinical indicators on the severity of early acute pancreatitis (AP). Materials and Methods: We collected 180 cases of AP patients admitted to our hospital from January 2020 to December 2023, and divided them into 32 cases of severe acute pancreatitis group (SAP group) and 148 cases of non-SAP group (non-SAP group) according to the severity of the disease. Comparing the clinical indexes of the two groups, the variables were included in logistic regression analysis to explore the independent risk factors of SAP, and were incorporated into R software to construct a predictive Nomogram model, and the predictive efficacy was evaluated by using subjects' work characteristic curves (ROC), and plotting calibration curves. Results: MCTSI score (OR=6.358, 95% CI:3.214-15.348), C-reactive protein (CRP) (OR=3.061, 95% CI:1.325-7.730), blood creatinine (Cr) (OR=1.032, 95% CI:1.020-1.041), and calcium (Ca2+) (OR=0.040, 95% CI:0.008-0.173) were independent risk factors for the occurrence of SAP (P<0.05). (95% CI:0.008-0.173) were independent risk factors for the occurrence of SAP (P<0.05). The results of ROC curve analysis showed that the Nomogram model had a high predictive value for the occurrence of SAP, with an area under the curve (AUC) of 0.910, which was significantly higher than the MCTSI score (AUC of 0.809), CRP (AUC of 0.790), Cr (AUC of 0.736), and Ca2+ (AUC of 0.781). Conclusion: The construction of a Nomogram model by combining MCTSI score, CRP, Cr, and D-D has an important application in the early prediction of AP severity.
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