Document Detail


Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system.
MedLine Citation:
PMID:  17312456     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To introduce a new scoring system based on signs of systemic inflammation on computed tomography (CT) [ExtraPancreatic Inflammation on CT (EPIC) score] and evaluate this score as an early prognostic tool. METHODS: Forty patients with acute pancreatitis who received an abdominal CT within 24 h after admission were included in the study. The Balthazar score, the CT Severity Index, and the EPIC score (based on the presence of pleural effusion, ascites, and retroperitoneal fluid collections) were calculated for all patients. The end points were the occurrence of severe acute pancreatitis (local complication or presence of organ failure for more than 48 h) and in hospital mortality. This score was evaluated by calculating receiver operator characteristic (ROC) curves and the area under the ROC curve. RESULTS: Mean age of the patients was 50 (+/-17.7) years, and Ranson score was 3.3. Fourteen (35%) patients developed severe disease; in hospital mortality was 15% (6/40). The mean EPIC score was 3.6 (+/-2.0). The area under the ROC curve for predicting severe disease and mortality was 0.91 (95% confidence interval, 0.83-0.99) and 0.85 (95% confidence interval, 0.71-0.99), respectively. An EPIC score of 4 or more had a 100% sensitivity and 70.8% specificity for predicting severe pancreatitis. The EPIC score was superior to the Balthazar score and CT Severity Index to predict outcome. CONCLUSIONS: In patients with acute pancreatitis, extrapancreatic inflammation assessed by abdominal CT scan and quantified with the EPIC score allows accurate estimation of disease severity and mortality within 24 h of admission.
Authors:
Jan J De Waele; Louke Delrue; Eric A Hoste; Martine De Vos; Philippe Duyck; Francis A Colardyn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pancreas     Volume:  34     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-21     Completed Date:  2007-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-90     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. jan.dewaele@UGent.be
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Ascites / immunology,  mortality,  radiography*
Cohort Studies
Early Diagnosis
Female
Humans
Male
Middle Aged
Pancreatitis / immunology,  mortality,  radiography*
Pleural Effusion / immunology,  mortality,  radiography*
Predictive Value of Tests
Prognosis
Radiography, Abdominal / statistics & numerical data*
Retroperitoneal Space
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index*
Tomography, X-Ray Computed / statistics & numerical data*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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