Journal of Health Science and Medical Research (JHSMR) (May 2022)

Comparison of CT Severity Index and Modified CT Severity Index in the Clinical Severity Assessment of Acute Pancreatitis

  • Piyaporn Apisarnthanarak,
  • Pattira Boonsri,
  • Voraparee Suvannarerg,
  • Walailak Chaiyasoot,
  • Supot Pongprasobchai,
  • Anucha Apisarnthanarak

DOI
https://doi.org/10.31584/jhsmr.2021854
Journal volume & issue
Vol. 40, no. 4
pp. 425 – 435

Abstract

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Objective: To compare the computed tomography severity index (CTSI) and the modified computed tomography severity index (MCTSI) in the clinical severity assessment of acute pancreatitis. Material and Methods: This retrospective cohort study comprised acute pancreatitis patients who underwent contrastenhanced abdominal computed tomography (CT) scans within 4 weeks after clinical onset. Two experienced abdominal radiologists, blinded to the clinical outcome, independently reviewed the CT images and retrospectively scored them using CTSI and MCTSI. Any discrepancies were resolved by a consensus review. The clinical severity assessment of each participant was categorized by the determinant-based classification of acute pancreatitis severity. The correlations of CTSI and MCTSI with the clinical severity assessment were analyzed. Results: This cohort study consisted of 40 participants—28 of them were men (70.0%)—with a mean age of 59.3 years. They were clinically divided into mild, moderate, severe, and critical groups comprising 11 (27.5%), 16 (40.0%), 7 (17.5%), and 6 (15.0%) participants, respectively. Due to the small number of patients in the severe and critical groups, we combined these into a single severe category (13 patients, 32.5%). The CTSI and MCTSI scores showed moderate and fair agreement with the clinical severity assessment. A trend linking poor clinical outcome with high CTSI/MCTSI scores (moderate and severe groups) more commonly than low scores (mild group) was observed. There was a very strong agreement between CTSI and MCTSI (rs =0.97). Conclusion: CTSI and MCTSI showed a moderate and fair agreement, respectively, with the clinical severity assessment. Compared to low scores, a poor clinical outcome was more often associated with high CTSI/MCTSI scores.

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