engleski

Computed tomography severity index is the best predictor of acute pancreatitis severity.

Introduction: Several score systems and biochemical markers have been developed for early prediction of severe acute pancreatitis (AP), namely development of complications. Objectives: Our purpose was to test the predictive value of some biochemical markers, clinical score systems, and computed tomography severity index (CTSI), in a development of systemic complications in AP. Materials and Methods: A retrospective study of 220 patients (49% male and 51% female), median age 64 in a 4- year period (2004-2008) was done. Serum level measurements of IL-6 and sTNFα-RI were performed by commercially available ELISA kits. CTSI was calculated according to Balthazar’s method. APACHE II and Ranson score were calculated according to the references. The prognostic value of previously mentioned parameters was calculated by receiver operating characteristics. Results: The best predictor for development of systemic complications in AP was CTSI at cut off value 3 (AUC 0.83, p<0.01) with sensitivity and specificity 81% and 84%, respectively. All other biochemical markers and scoring systems showed significant (p <0.05), but much lower predictive value (AUC 0.67-0.75) than CTSI. Conclusion: CTSI is very useful scoring system in assessing severity of AP. Although APACHE II and Ranson scores as well as some biochemical markers can predict complications, their accuracy comparing to CTSI is much lower.

Acute pancreatitis; severity; CTSI

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