Abstract
OBJECTIVE. The purpose of this study was to compare the modified CT severity index (MCTSI) with the CT severity index (CTSI) regarding assessment of severity parameters in acute pancreatitis (AP). Both CT indexes were also compared with the Acute Physiology, Age, and Chronic Health Evaluation (APACHE II) index. MATERIALS AND METHODS. Of 397 consecutive cases of AP, 196 (49%) patients underwent contrast-enhanced CT (n = 175) or MRI (n = 21) within 1 week of onset of symptoms. Two radiologists independently scored both CT indexes. Severity parameters included mortality, organ failure, pancreatic infection, admission to and length of ICU stay, length of hospital stay, need for intervention, and clinical severity of pancreatitis. Discrimination analysis and kappa statistics were performed. RESULTS. Although for both CT indexes a significant relationship was observed between the score and each severity parameter (p <0.0001), no significant differences were seen between the CT indexes. Compared with the APACHE II index, both CT indexes more accurately correlated with the need for intervention (CTSI, p = 0.006; MCTSI, p = 0.01) and pancreatic infection (CTSI, p = 0.04; MCTSI, p = 0.06) and more accurately diagnosed clinically severe disease (area under the curve, 0.87; 95% CI, 0.82-0.92). Interobserver agreement was excellent for both indexes: for CTSI, 0.85 (95% CI, 0.80-0.90) and for MCTSI, 0.90 (95% CI, 0.85-0.95). CONCLUSION. No significant differences were noted between the CTSI and the MCTSI in evaluating the severity of AP. Compared with APACHE II, both CT indexes more accurately diagnose clinically severe disease and better correlate with the need for intervention and pancreatic infection.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 386-392 |
| Number of pages | 7 |
| Journal | American Journal of Roentgenology |
| Volume | 197 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 2011 |
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Keywords
- Acute pancreatitis
- CT severity index (CTSI)
- Modified CTSI (MCTSI)
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Comparative evaluation of the modified CT severity index and CT severity index in assessing severity of acute pancreatitis. / Bollen, Thomas L.; Singh, Vikesh; Maurer, Rie; Repas, Kathryn; Van Es, Hendrik W.; Banks, Peter A.; Mortele, Koenraad J.
In: American Journal of Roentgenology, Vol. 197, No. 2, 08.2011, p. 386-392.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparative evaluation of the modified CT severity index and CT severity index in assessing severity of acute pancreatitis
AU - Bollen, Thomas L.
AU - Singh, Vikesh
AU - Maurer, Rie
AU - Repas, Kathryn
AU - Van Es, Hendrik W.
AU - Banks, Peter A.
AU - Mortele, Koenraad J.
PY - 2011/8
Y1 - 2011/8
N2 - OBJECTIVE. The purpose of this study was to compare the modified CT severity index (MCTSI) with the CT severity index (CTSI) regarding assessment of severity parameters in acute pancreatitis (AP). Both CT indexes were also compared with the Acute Physiology, Age, and Chronic Health Evaluation (APACHE II) index. MATERIALS AND METHODS. Of 397 consecutive cases of AP, 196 (49%) patients underwent contrast-enhanced CT (n = 175) or MRI (n = 21) within 1 week of onset of symptoms. Two radiologists independently scored both CT indexes. Severity parameters included mortality, organ failure, pancreatic infection, admission to and length of ICU stay, length of hospital stay, need for intervention, and clinical severity of pancreatitis. Discrimination analysis and kappa statistics were performed. RESULTS. Although for both CT indexes a significant relationship was observed between the score and each severity parameter (p <0.0001), no significant differences were seen between the CT indexes. Compared with the APACHE II index, both CT indexes more accurately correlated with the need for intervention (CTSI, p = 0.006; MCTSI, p = 0.01) and pancreatic infection (CTSI, p = 0.04; MCTSI, p = 0.06) and more accurately diagnosed clinically severe disease (area under the curve, 0.87; 95% CI, 0.82-0.92). Interobserver agreement was excellent for both indexes: for CTSI, 0.85 (95% CI, 0.80-0.90) and for MCTSI, 0.90 (95% CI, 0.85-0.95). CONCLUSION. No significant differences were noted between the CTSI and the MCTSI in evaluating the severity of AP. Compared with APACHE II, both CT indexes more accurately diagnose clinically severe disease and better correlate with the need for intervention and pancreatic infection.
AB - OBJECTIVE. The purpose of this study was to compare the modified CT severity index (MCTSI) with the CT severity index (CTSI) regarding assessment of severity parameters in acute pancreatitis (AP). Both CT indexes were also compared with the Acute Physiology, Age, and Chronic Health Evaluation (APACHE II) index. MATERIALS AND METHODS. Of 397 consecutive cases of AP, 196 (49%) patients underwent contrast-enhanced CT (n = 175) or MRI (n = 21) within 1 week of onset of symptoms. Two radiologists independently scored both CT indexes. Severity parameters included mortality, organ failure, pancreatic infection, admission to and length of ICU stay, length of hospital stay, need for intervention, and clinical severity of pancreatitis. Discrimination analysis and kappa statistics were performed. RESULTS. Although for both CT indexes a significant relationship was observed between the score and each severity parameter (p <0.0001), no significant differences were seen between the CT indexes. Compared with the APACHE II index, both CT indexes more accurately correlated with the need for intervention (CTSI, p = 0.006; MCTSI, p = 0.01) and pancreatic infection (CTSI, p = 0.04; MCTSI, p = 0.06) and more accurately diagnosed clinically severe disease (area under the curve, 0.87; 95% CI, 0.82-0.92). Interobserver agreement was excellent for both indexes: for CTSI, 0.85 (95% CI, 0.80-0.90) and for MCTSI, 0.90 (95% CI, 0.85-0.95). CONCLUSION. No significant differences were noted between the CTSI and the MCTSI in evaluating the severity of AP. Compared with APACHE II, both CT indexes more accurately diagnose clinically severe disease and better correlate with the need for intervention and pancreatic infection.
KW - Acute pancreatitis
KW - CT severity index (CTSI)
KW - Modified CTSI (MCTSI)
UR - http://www.scopus.com/inward/record.url?scp=79960715035&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960715035&partnerID=8YFLogxK
U2 - 10.2214/AJR.09.4025
DO - 10.2214/AJR.09.4025
M3 - Article
C2 - 21785084
AN - SCOPUS:79960715035
VL - 197
SP - 386
EP - 392
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
SN - 0361-803X
IS - 2
ER -