Computed tomography versus Acute Physiology and Chronic Health Evaluation II score in predicting severity of acute pancreatitis: a prospective, comparative study with statistical evaluation.
OBJECTIVE
The aim of the study was to compare Acute Physiology and Chronic Health Evaluation II score and C-reactive protein as a clinical index and computed tomography-based severity index (CTSI) in predicting the course of acute pancreatitis.


METHODS
One hundred forty-eight patients with acute pancreatitis were enrolled in the study during a 2-year period. All data concerning etiology, Atlanta classification, CT findings, Acute Physiology and Chronic Health Evaluation score, C-reactive protein levels, stay in the intensive care unit, length of hospital stay, treatment, complications, and deaths were analyzed with Mann-Whitney U, Wilcoxon, Pearson, and Spearman statistical tests. The CT was performed on a spiral unit after intravenous administration of contrast material. Images were graded according to the Balthazar-CTSI scoring system.


RESULTS
A very good correlation was noticed between Balthazar-CTSI scores and local complications, whereas no statistically significant correlation was found between CT scores and stay in the intensive care unit. Among survivors and nonsurvivors, there were no statistically significant differences as far as CT scores were concerned.


CONCLUSIONS
Although the extent of necrosis as defined on contrast-enhanced CT examinations is considered as a risk factor for a negative prognosis, our findings suggest that the initially documented disease severity according only to imaging parameters is not highly important for the final patient outcome.
Triantopoulou
Charikleia
C
Computed Tomography Department, Konstantopoulio Agia Olga Hospital, Athens, Greece. chatri@mycosmos.gr
Lytras
Dimitrios
D
Maniatis
Petros
P
Chrysovergis
Dimitrios
D
Manes
Konstantinos
K
Siafas
Ioannis
I
Papailiou
John
J
Dervenis
Christos
C
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D003422:Critical Care / Q000706:statistics & numerical data; D004487:Edema / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D010195:Pancreatitis / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed
D002097:C-Reactive Protein