Prospective study of 310 patients: can early CT predict the severity of acute pancreatitis?
BACKGROUND
This study was designed to determine the most important early CT parameters predictive of acute pancreatitis severity.


METHODS
Three hundred and seventy-one consecutive patients with acute abdominal pain and hyperamylasemia were enrolled. Three hundred and ten of the 371 patients met our inclusion criteria. Acute pancreatitis severity was evaluated using the 1992 Atlanta criteria. Different CT parameters were reported from the admission abdominal CT by two radiologists blinded from any clinical parameter, but the patients' age and gender. These variables were fitted in a binary logistic regression model.


RESULTS
Acute pancreatitis was mild in 80% cases, severe in 20% cases and lethal in 12.69% cases. The following CT parameters were significantly associated with the severity of acute pancreatitis: the objective size of the pancreas (P = 0.001), the peripancreatic fat abnormalities (P = 0.001) and the extent of necrosis (P = 0.007). Moreover, the age of the patient revealed itself a highly significant (P = 0.001) indicator of disease severity. The association of the four CT criteria eventually showed a sensitivity of 73% and a specificity of 81% to predict acute pancreatitis severity.


CONCLUSIONS
Although these criteria correlated with disease severity, our study identified that morphological CT criteria cannot be used to triage patients with severe and mild acute pancreatitis.
Knoepfli
A-S
AS
Department of Radiology, Geneva University Hospital, Geneva, Switzerland. anne-sophie.knoepfli@hcuge.ch
Kinkel
K
K
Berney
T
T
Morel
P
P
Becker
C D
CD
Poletti
P-A
PA
D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D005544:Forecasting; D006801:Humans; D034321:Hyperamylasemia / Q000000981:diagnostic imaging; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010179:Pancreas / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000145:classification* / Q000000981:diagnostic imaging; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*