Modified Computed Tomography Severity Index in Acute Pancreatitis - Its Correlation with Patient Morbidity (A Study of 40 Cases)
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 2
Abstract
Background: In the past two decades, several radiologic prognostic scoring systems have been developed. This study was aimed to study the correlation of modified computed tomography severity index (MCTSI) with patient’s morbidity and comparison of the CTSI with the MCTSI and to evaluate necrosis as a predictor of patient morbidity. Methods: The patients clinically suspected to have acute pancreatitis subjected to contrast-enhanced computed tomography (CECT) abdomen. The morphologic severity of pancreatitis was assessed using the CTSI, developed by Balthazar and the MCTSI. CTSI and MCTSI were compared in their ability to individually predict hospital stay, the development of local complications, systemic complications, a fatal outcome and their ability to pick up patients who eventually had severe disease. Necrosis on CECT was evaluated as a separate index in its usefulness in the prediction of severe course of the disease and mortality. Results: Both the indices CTSI and MCTSI did not show an association with duration of hospital stay or the need of surgery or intervention in a patient. Both indices (CTSI and MCTSI) showed association with the development of local complications and organ failure. MCTSI showed better sensitivity than CTSI and shows good specificity, positive, and negative predictive values as a predictor of local complications and organ failure. Necrosis showed an association with patient morbidity (development of local complications) with high positive and negative predictive values (84.6% and 81.4%, respectively) and sensitivity of 68.7 % and specificity of 91.6%. Conclusions: MCTSI is more accurate index to predict the development of local complications or organ failure. However, both are less accurate in their ability to predict the need for surgical intervention and longer hospital stay. Necrosis as an independent index is a useful marker for predicting the development of local complications.
Authors and Affiliations
Manisha Lokwani, N A Patel
Keywords
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