Persistent SIRS and acute fluid collections are associated with increased CT scanning in acute interstitial pancreatitis

Ayesha Kamal, Mahya Faghih, Robert A. Moran, Elham Afghani, Amitasha Sinha, Nasim Parsa, Martin A Makary, Atif Zaheer, Elliot K Fishman, Mouen Khashab, Anthony N Kalloo, Vikesh Singh

Research output: Contribution to journalArticle

Abstract

Background: The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine. Aim: To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP). Methods: Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI) ≤ 3 on a CT obtained within 48 h of presentation were included. Results: A total of 229 patients were included, of whom 206 (90%) had a single CT and 23 (10%) had >1 CT during the first week of hospitalization. Patients undergoing >1 CT had significantly higher rates of acute fluid collection (AFC), persistent SIRS, opioid use ≥4 days, and persistent organ failure compared to those undergoing 1 CT (p < .05 for all). On multivariable analysis, only persistent SIRS (OR = 3.6, 95% CI 1.4–9.6, p = .01) and an AFC on initial CT (OR = 3.5, 95% CI 1.4–9, p = .009) were independently associated with obtaining >1 CT. Conclusion: An AFC on initial CT and persistent SIRS are associated with increased CT imaging in AIP patients. However, these additional CT scans did not change clinical management.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalScandinavian Journal of Gastroenterology
DOIs
StateAccepted/In press - Oct 5 2017

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Pancreatitis
Tomography
Clinical Medicine
Diagnostic Imaging
Opioid Analgesics
Hospitalization
Demography

Keywords

  • acute fluid collection
  • Acute pancreatitis
  • CT scans
  • persistent SIRS

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Persistent SIRS and acute fluid collections are associated with increased CT scanning in acute interstitial pancreatitis",
abstract = "Background: The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine. Aim: To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP). Methods: Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI) ≤ 3 on a CT obtained within 48 h of presentation were included. Results: A total of 229 patients were included, of whom 206 (90{\%}) had a single CT and 23 (10{\%}) had >1 CT during the first week of hospitalization. Patients undergoing >1 CT had significantly higher rates of acute fluid collection (AFC), persistent SIRS, opioid use ≥4 days, and persistent organ failure compared to those undergoing 1 CT (p < .05 for all). On multivariable analysis, only persistent SIRS (OR = 3.6, 95{\%} CI 1.4–9.6, p = .01) and an AFC on initial CT (OR = 3.5, 95{\%} CI 1.4–9, p = .009) were independently associated with obtaining >1 CT. Conclusion: An AFC on initial CT and persistent SIRS are associated with increased CT imaging in AIP patients. However, these additional CT scans did not change clinical management.",
keywords = "acute fluid collection, Acute pancreatitis, CT scans, persistent SIRS",
author = "Ayesha Kamal and Mahya Faghih and Moran, {Robert A.} and Elham Afghani and Amitasha Sinha and Nasim Parsa and Makary, {Martin A} and Atif Zaheer and Fishman, {Elliot K} and Mouen Khashab and Kalloo, {Anthony N} and Vikesh Singh",
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doi = "10.1080/00365521.2017.1383510",
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T1 - Persistent SIRS and acute fluid collections are associated with increased CT scanning in acute interstitial pancreatitis

AU - Kamal, Ayesha

AU - Faghih, Mahya

AU - Moran, Robert A.

AU - Afghani, Elham

AU - Sinha, Amitasha

AU - Parsa, Nasim

AU - Makary, Martin A

AU - Zaheer, Atif

AU - Fishman, Elliot K

AU - Khashab, Mouen

AU - Kalloo, Anthony N

AU - Singh, Vikesh

PY - 2017/10/5

Y1 - 2017/10/5

N2 - Background: The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine. Aim: To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP). Methods: Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI) ≤ 3 on a CT obtained within 48 h of presentation were included. Results: A total of 229 patients were included, of whom 206 (90%) had a single CT and 23 (10%) had >1 CT during the first week of hospitalization. Patients undergoing >1 CT had significantly higher rates of acute fluid collection (AFC), persistent SIRS, opioid use ≥4 days, and persistent organ failure compared to those undergoing 1 CT (p < .05 for all). On multivariable analysis, only persistent SIRS (OR = 3.6, 95% CI 1.4–9.6, p = .01) and an AFC on initial CT (OR = 3.5, 95% CI 1.4–9, p = .009) were independently associated with obtaining >1 CT. Conclusion: An AFC on initial CT and persistent SIRS are associated with increased CT imaging in AIP patients. However, these additional CT scans did not change clinical management.

AB - Background: The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine. Aim: To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP). Methods: Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI) ≤ 3 on a CT obtained within 48 h of presentation were included. Results: A total of 229 patients were included, of whom 206 (90%) had a single CT and 23 (10%) had >1 CT during the first week of hospitalization. Patients undergoing >1 CT had significantly higher rates of acute fluid collection (AFC), persistent SIRS, opioid use ≥4 days, and persistent organ failure compared to those undergoing 1 CT (p < .05 for all). On multivariable analysis, only persistent SIRS (OR = 3.6, 95% CI 1.4–9.6, p = .01) and an AFC on initial CT (OR = 3.5, 95% CI 1.4–9, p = .009) were independently associated with obtaining >1 CT. Conclusion: An AFC on initial CT and persistent SIRS are associated with increased CT imaging in AIP patients. However, these additional CT scans did not change clinical management.

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