title: Clinical, biochemical, and radiologic parameters at admission predicting formation of a pseudocyst in acute pancreatitis.
abstract: OBJECTIVE
  To evaluate clinical, biochemical, and radiologic parameters at admission, which predict the development of acute pseudocyst (AP) after acute pancreatitis.
  
  
  BACKGROUND
  There is limited data on factors that predict the development of AP.
  
  
  METHODS
  Seventy-five consecutive patients with AP were prospectively enrolled and subjected to clinical, laboratory, and radiologic investigation. The patients were followed up for a period of 4 weeks and then investigated radiologically for the development of AP.
  
  
  RESULTS
  After exclusion, 65 patients (44 males) were studied. The median age was 37 years (40.9±15.5 y). Etiology of acute pancreatitis was alcohol in 24 patients, gallstones in 18, both in 4, drugs in 4, pancreas divisum in 2, postendoscopic retrograde cholangiopancreatography in 1, trauma in 1, and idiopathic in 11 patients. On admission, acute fluid collections were observed in 34 (52.31%) patients. Necrosis was noted in 38 (58.46%) patients (<30% necrosis, 30% to 50% necrosis, and >50% necrosis was observed in 36.8%, 26.3%, and 36.8% patients, respectively). On follow-up, 34 (52.3%) patients developed a pseudocyst. On univariate analysis, the factors significantly associated with pseudocyst formation were male sex, palpable mass, blood sugar greater than 150 mg/dL, necrosis, sepsis, acute fluid collections, presence of ascites, pleural effusion, a high grade of pancreatitis, and a high computed tomography severity index (CTSI) score. Multivariate regression analysis showed that male sex, presence of a palpable abdominal mass, ascites, and a high CTSI score were associated with the development of AP.
  
  
  CONCLUSIONS
  Male sex, palpable mass, ascites, and a high CTSI score at admission can predict the development of a pseudocyst after an attack of acute pancreatitis. Acute pancreatitis patients with these parameters at admission should be closely followed for the development of a pseudocyst.
authors.affiliation: Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Kuchhangi Sureshchandra
authors.initials: KS
authors.lastname: Poornachandra
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Bhasin
authors.forename: Birinder
authors.initials: B
authors.lastname: Nagi
authors.forename: Saroj Kant
authors.initials: SK
authors.lastname: Sinha
authors.forename: Surinder Singh
authors.initials: SS
authors.lastname: Rana
authors.forename: Nusrat
authors.initials: N
authors.lastname: Shafiq
authors.forename: Katarina
authors.initials: K
authors.lastname: Greer
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Mandeep
authors.initials: M
authors.lastname: Kang
authors.forename: Samir
authors.initials: S
authors.lastname: Malhotra
authors.forename: Kartar
authors.initials: K
authors.lastname: Singh
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult