Role of Modified CT Severity Index in Assessment of Acute Pancreatitis at Tertiary Care Hospital
Objective: To evaluate the diagnostic role of Modified CT Severity Index (MCTSI) in terms of severity of disease process and its complication in correlation to APACHE II score.
Patients and Methods: This cross-sectional study was conducted in CT & MRI Centre, Dow University of Health Sciences/ Dr. Ruth K. M. Pfau Civil Hospital Karachi, from 1st July to 31st December 2017. This study includes 93 patients with clinical features of acute pancreatitis referred to our department for contrast enhanced CT of abdomen within 24 hours of presentation. Patients were selected according to the study criterion. The pancreatitis was classified into mild, moderate and severe disease in term of severity by modified CT severity index. APACHE II score was calculated within 24 hours of admission. Clinical outcome parameters in terms of any intervention, systemic infection, organ failure and mortality were also collected. Results: Mean age of the patients was 39.82 + 12.04 years in the range of 20-70 years. Majority of patients were categorized as moderate pancreatitis (45.16%) according to Modified CT severity index followed by severe pancreatitis in 36 (38.71%) patients and mild pancreatitis in 15 (16.13%). Raised APACHE II score was observed in patients of severe pancreatitis. The clinical outcome parameters in terms of need of intervention, development of infection, organ failure and death rates, were also increased in patients with higher MCTSI.
Conclusion: Contrast enhanced CT had an excellent diagnostic value to assess the disease extent and to grade its severity. Modified CTSI is a simplified and powerful tool with good sensitivity and specificity to assess the severe acute pancreatitis in correlation to APACHE II.
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