Computed tomography severity index is a predictor of outcomes for severe pancreatitis

• Published in: The American journal of surgery 2000-05, Vol.179 (5), p.352-355
• Main Authors: Simchuk, Erik J, Traverso, L.William, Nukui, Yuji, Kozarek, Richard A
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; APACHE; Biological and medical sciences; Chi-Square Distribution; Computed tomography; Criteria; Cysts; Death; Death & dying; Entrances; Etiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hospital Mortality; Hospitals; Humans; Length of stay; Length of Stay - statistics & numerical data; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical imaging; Medical sciences; Middle Aged; Mortality; Necrosis; Other diseases. Semiology; Pancreas; Pancreatitis; Pancreatitis - classification; Pancreatitis - diagnostic imaging; Pancreatitis - mortality; Pancreatitis - pathology; Pancreatitis - surgery; Patient Admission - statistics & numerical data; Patient Admission - trends; Patients; Predictive Value of Tests; Prognosis; Reproducibility of Results; Retrospective Studies; Severity of Illness Index; Statistical analysis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tomography, X-Ray Computed - standards; Treatment Outcome; Variables
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(00)00375-5

Background: In a small group of patients with acute pancreatitis, Balthazar and Ranson demonstrated the applicability of computed tomography (CT) criteria to predict mortality. Building upon their work with a larger group of patients with acute pancreatitis, we set out not only to demonstrate that the CT severity index can predict death, but also length of hospital stay and need for necrosectomy. Methods: We reviewed all patients admitted to our hospital in the years 1992 to 1997 with a primary diagnosis of acute pancreatitis. Entrance criteria required that a CT scan had been performed during the hospitalization. The index CT scan was used to determine a CT severity index (the CTSI of Balthazar and Ranson). Outcomes measured were death, length of stay (LOS), and need for necrosectomy (NEC). Statistical analysis was performed using Fisher’s exact and chi-square tests where appropriate. Results: Between the years 1992 to 1997, 886 patients had 1,774 admissions for acute pancreatitis, of which 268 had a CT scan performed and were entered into our study. These 268 patients had a mean age of 57 years, a mean LOS of 16 days (1 to 118), and a mean CTSI of 3.9 (0 to 10). Overall mortality was 4% (n = 11). A CTSI >5 significantly correlated with death ( P = 0.0005), prolonged hospital stay ( P