Severe acute pancreatitis requiring drainage therapy: findings on computed tomography as predictor of patient outcome.
OBJECTIVE
To evaluate whether morphologic features on computed tomography (CT) correlate with outcome of patients with severe acute pancreatitis (SAP).


METHODS
80 patients with SAP requiring percutaneous drainage therapy were retrospectively analyzed. Twelve CT features beyond the CT severity index (CTSI) were studied. Endpoints for patient outcome were patient death, length of hospital and ICU stay. The twelve features and the CTSI score were correlated with mortality using Kaplan-Meier estimator and correlated with length of hospital and ICU stay using the χ(2) test. A p value ≤0.05 was considered statistically significant.


RESULTS
Two CT features exhibited a significant correlation with mortality: (1) the number of parts of pancreas (head, corpus, tail) that exhibited areas of necrosis and (2) the presence of distant fluid collections (posterior pararenal space and/or paracolic gutter). Mortality was 42% (21 of 50 patients) and 20% (6 of 30 patients) if two/all three parts or none/one part of the pancreas exhibited necrosis, respectively. Mortality was 46% (18 of 39 patients) and 22% (9 of 41 patients) if distant fluid collections were present or absent, respectively. All other imaging features including the CTSI showed no significant correlation with patient outcome.


CONCLUSIONS
We identified two morphologic features on CT that might be helpful to predict prognosis of patients suffering from SAP. and IAP.
Department of Radiology, University Medical Center Regensburg, Regensburg, Germany. heiss.peter@web.de
P
P
Heiss
T
T
Bruennler
B
B
Salzberger
S
S
Lang
J
J
Langgartner
S
S
Feuerbach
J
J
Schoelmerich
O W
OW
Hamer
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001201:Ascites / Q000473:pathology; D003422:Critical Care; D004322:Drainage / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D010179:Pancreas / Q000473:pathology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D055815:Young Adult