SEVERITY ASSESSMENT OF ACUTE PANCREATITIS USING SEVERITY INDICES, REVISED ATLANTA CLASSIFICATION AND CORRELATING WITH CLINICAL OUTCOMES

Abstract

To determine the prognostic efficacy of CT severity index, Modified CT severity index and Revised Atlanta Classification in acute pancreatitis. Materials and method: This prospective study was carried out from February 2019 to June 2020 on 42 patients who were referred to the Dept. of Radiodiagnosis, GMCH with acute pancreatitis and underwent the contrast enhanced CT after 72 hours of onset of symptoms. The severity of pancreatitis was assessed and scored using CTSI, MCTSI and RAC. Clinical outcome parameters included duration of hospital stay and ICU, presence of persistent organ failure (OF), evidence of infection, need for intervention, and mortality. Results: Out of 42 cases, 33 were males, age group 20-85 years (mean 47.69 ± 16.32). As per CTSI 61.9% had mild, 35.7% moderate and 2.4% severe pancreatitis. Based on MCTSI grading, 21.4% had mild, 59.6% moderate and 19% severe pancreatitis. Based on RAC grading, 31% had mild, 52.4% moderate and 16.6% severe pancreatitis. Area under the curve were generated using ROC analysis. Duration of stay of the patients, presence of organ failure and the evidence of infection was significantly associated with CTSI, MCTSI and RAC (P < 0.001). Need for intervention was significantly associated with only MCTSI. Conclusion: ROC analysis of the three scoring systems for the prediction of various patient outcomes in our study revealed that the AUCs overlap, showing all the three scoring systems performed well. Duration of stay of the patients, presence of organ failure and the evidence of infection was significantly associated with CTSI, MCTSI and RAC (P < 0.001). Need for intervention was significantly associated with only MCTSI.