Diagnostic Accuracy of Modified CT Severity Index in Assessing Severity of Acute Pancreatitis.

OBJECTIVE

To determine the diagnostic accuracy of modified CT severity index in assessing the severe acute pancreatitis keeping APACHE II as gold standard.

STUDY DESIGN

Cross-sectional (validation) study.

PLACE AND DURATION OF STUDY

Department of Radiology, Allied Hospital, Faisalabad, from February to August 2014.

METHODOLOGY

A total of 120 patients of either gender aged 20-60 years with epigastric pain radiating to back and having sonographic findings (decreased or heterogeneous pancreatic echogenicity, pancreatic enlargement, peripancreatic fluid collection), supportive of acute pancreatitis were taken. CT with intravenous contrast was performed on 128-slice scanner within 24 hours of presentation. Slice thickness was 3 mm in region of pancreas. Modified CT severity index was calculated. Score above 5 was graded as severe pancreatitis. APACHE II score of >11 considered as gold standard was also calculated within 24 hours of admission.

RESULTS

Mean age of the patients was 39.03 ±8.71 years. Most of the patients were females 73 (60.8%). Out of 120 patients, 43 (35.83%) patients had severe acute pancreatitis. Sensitivity, specificity, positive predictive value and negative predictive value of modified CT severity index in assessing the severe acute pancreatitis were 100%, 87%, 81.13% and 100%, respectively. The diagnostic accuracy was yielded as 91.67% considered APACHE II as gold standard.

CONCLUSION

Modified CT severity index had high diagnostic accuracy in assessment of severe acute pancreatitis and can be used reliably in early prediction of complications of severe acute pancreatitis.