Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study
Background: Acute Pancreatitis is a very common condition leading to the emergency visits in both developed and developing countries. Computed Tomography plays a pivotal role in the diagnosis and subsequent management of pancreatitis. The modified CT severity index includes a simplified assessme...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2015-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/6368/14824_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| _version_ | 1798045792758398976 |
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| author | Irshad Ahmad Banday Imran Gattoo Azher Maqbool Khan Jasima Javeed Ghanshyam Gupta Mohmad Latief |
| author_facet | Irshad Ahmad Banday Imran Gattoo Azher Maqbool Khan Jasima Javeed Ghanshyam Gupta Mohmad Latief |
| author_sort | Irshad Ahmad Banday |
| collection | DOAJ |
| description | Background: Acute Pancreatitis is a very common condition
leading to the emergency visits in both developed and developing
countries. Computed Tomography plays a pivotal role in the
diagnosis and subsequent management of pancreatitis. The
modified CT severity index includes a simplified assessment of
pancreatic inflammation and necrosis as well as an assessment of
extra pancreatic complications.
Aim: To study role of modified computed tomography severity
index in evaluation of acute pancreatitis and its correlation with
clinical outcome.
Materials and Methods: This was a hospital based prospective
correlative study done on patients of all age groups referred to
the Department of Radio diagnosis from the various indoor and
outdoor departments of the hospital, with clinical/Laboratory/
ultrasonography findings suggestive of acute pancreatitis. The
severity of pancreatitis was scored using Modified CT severity
index & CT severity index and classified into mild, moderate
and severe categories. Total of 50 patients of acute pancreatitis
presenting to the emergency department of our hospital were
included in the study. Clinical outcome parameters for correlation
collected from respective referral departments included, the length
of hospital stay (in days), need for surgical intervention, need for
percutaneous intervention (aspiration and drainage), evidence of
infection in any organ system (combination of a fever > 100°F and
elevated WBC >15,000/ mm³), evidence of organ failure (PaO2
<
60 mm Hg or need of ventilation, systolic BP of < 90 mm Hg,
serum creatinine of >300µmoles/L or urine output of < 500 ml /
24 h) and death.
Results: The age of the patients in the study group was in the
range of 17 to 80 years. Maximum patients were in the age group
40-50 years (42.0%). The mean age was 42.32 years. Out of 50
cases, 33 (66%) were male and 17 (34%) were females with a
male to female ratio of 2:1. Cholelithiasis was found to be most
common aetiological factor for acute pancreatitis in 40% cases.
Alcoholic pancreatitis was seen in 36% of cases. Together
cholelithiasis and alcoholism accounted for 76% of cases. Pleural
effusion was the most common extra-pancreatic complication,
28 patients (56%), followed by ascites. Majority of patients were
categorized as severe pancreatitis (44%). 38% patients were
grouped into moderate pancreatitis and 18% were categorized in
mild pancreatitis. The outcome parameters in terms of length of
hospital stay, need of intervention, development of infection, and
development of organ failure were more in patients with higher
modified CT severity index.
Conclusion: In conclusion CECT was found to be an excellent
imaging modality for diagnosis, establishing the extent of disease
process and in grading its severity. The Modified CT Severity Index
is a simpler scoring tool and more accurate than the Balthazar
CT Severity Index. In this study, it had a stronger statistical
correlation with the clinical outcome, be it the length of hospital
stay, development of infection, occurrence of organ failure and
overall mortality. It could also predict the need for interventional
procedures. |
| first_indexed | 2024-04-11T23:26:50Z |
| format | Article |
| id | doaj.art-b01aec93f5d34685bc2e09ea513f78c6 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-11T23:26:50Z |
| publishDate | 2015-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-b01aec93f5d34685bc2e09ea513f78c62022-12-22T03:57:17ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-08-0198TC01TC0510.7860/JCDR/2015/14824.6368Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational StudyIrshad Ahmad Banday0Imran Gattoo1Azher Maqbool Khan2Jasima Javeed3Ghanshyam Gupta4Mohmad Latief5Resident, Post Graduate, Department of Radiodiagnosis, Government Medical College Jammu, J&K, India.Registrar, Post Graduate, Department of Paediatrics, Government Medical College Srinagar, J&K, India.Registrar, Department of Radiodiagnosis, SKIMS, Srinagar, J&K, India.Resident, Government Medical College Srinagar, J&K, India.Professor and Head, Post Graduate Department of Radiodiagnosis, Government Medical College Jammu, India.Resident, Government Medical College Srinagar, J&K, India.Background: Acute Pancreatitis is a very common condition leading to the emergency visits in both developed and developing countries. Computed Tomography plays a pivotal role in the diagnosis and subsequent management of pancreatitis. The modified CT severity index includes a simplified assessment of pancreatic inflammation and necrosis as well as an assessment of extra pancreatic complications. Aim: To study role of modified computed tomography severity index in evaluation of acute pancreatitis and its correlation with clinical outcome. Materials and Methods: This was a hospital based prospective correlative study done on patients of all age groups referred to the Department of Radio diagnosis from the various indoor and outdoor departments of the hospital, with clinical/Laboratory/ ultrasonography findings suggestive of acute pancreatitis. The severity of pancreatitis was scored using Modified CT severity index & CT severity index and classified into mild, moderate and severe categories. Total of 50 patients of acute pancreatitis presenting to the emergency department of our hospital were included in the study. Clinical outcome parameters for correlation collected from respective referral departments included, the length of hospital stay (in days), need for surgical intervention, need for percutaneous intervention (aspiration and drainage), evidence of infection in any organ system (combination of a fever > 100°F and elevated WBC >15,000/ mm³), evidence of organ failure (PaO2 < 60 mm Hg or need of ventilation, systolic BP of < 90 mm Hg, serum creatinine of >300µmoles/L or urine output of < 500 ml / 24 h) and death. Results: The age of the patients in the study group was in the range of 17 to 80 years. Maximum patients were in the age group 40-50 years (42.0%). The mean age was 42.32 years. Out of 50 cases, 33 (66%) were male and 17 (34%) were females with a male to female ratio of 2:1. Cholelithiasis was found to be most common aetiological factor for acute pancreatitis in 40% cases. Alcoholic pancreatitis was seen in 36% of cases. Together cholelithiasis and alcoholism accounted for 76% of cases. Pleural effusion was the most common extra-pancreatic complication, 28 patients (56%), followed by ascites. Majority of patients were categorized as severe pancreatitis (44%). 38% patients were grouped into moderate pancreatitis and 18% were categorized in mild pancreatitis. The outcome parameters in terms of length of hospital stay, need of intervention, development of infection, and development of organ failure were more in patients with higher modified CT severity index. Conclusion: In conclusion CECT was found to be an excellent imaging modality for diagnosis, establishing the extent of disease process and in grading its severity. The Modified CT Severity Index is a simpler scoring tool and more accurate than the Balthazar CT Severity Index. In this study, it had a stronger statistical correlation with the clinical outcome, be it the length of hospital stay, development of infection, occurrence of organ failure and overall mortality. It could also predict the need for interventional procedures.https://jcdr.net/articles/PDF/6368/14824_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdfcholecystitispleural effusionpancreatitis |
| spellingShingle | Irshad Ahmad Banday Imran Gattoo Azher Maqbool Khan Jasima Javeed Ghanshyam Gupta Mohmad Latief Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study Journal of Clinical and Diagnostic Research cholecystitis pleural effusion pancreatitis |
| title | Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study |
| title_full | Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study |
| title_fullStr | Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study |
| title_full_unstemmed | Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study |
| title_short | Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study |
| title_sort | modified computed tomography severity index for evaluation of acute pancreatitis and its correlation with clinical outcome a tertiary care hospital based observational study |
| topic | cholecystitis pleural effusion pancreatitis |
| url | https://jcdr.net/articles/PDF/6368/14824_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
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