Use of CT-Based Scoring System in Assessment of Pancreatitis Severity

Abstract

BACKGROUND: Severity of AP is an important indicator of death rate, playing a crucial role in defining a correct dealing with a patient at his/her initial admission, in deciding on the need to transfer a patient to the intensive care unit. Many studies point out a direct relation between the death rate and the number of affected organs. In light of this, looking for the new criteria of multiple organ failure is still useful in clinical practice. Typically, assessment of multiple organ failure with patients undergoing treatment in the intensive care unit is carried out with the use of various integrated scores based both on clinical laboratory assessment of patient’s condition and on data obtained by advanced imaging methods. However, many scientists point out that the facilities of diagnostic radiology, including in particularly computerised tomography, are not used to the full extent.

AIM: We developed a CT score for assessment of pancreatitis severity that takes into consideration not only alterations of the pancreas but also enables evaluation of multiple organ failure with the examined patients.

METHODS: We have examined 100 patients with suspected pancreatitis. Among them 30 patients had pancreatitis without alterations of the vital organs; 70 patients had alterations of the vital organs, suffered organ or multiple organ failure and received treatment in the surgery unit and intensive care unit of the Department of Surgical Conditions of Karaganda Medical University.

RESULTS: Because of CT results, based on the proposed score, we assessed a degree of pancreas necrosis, analysed the relation between organ failure and degree of pancreas necrosis. Finally, we evaluated the connection between multiple organ failure and the specific failure of one organ and the presence of necrosis and death rate.

CONCLUSION: The proposed score for CT-based assessment of pancreatitis severity can be used not only for identification but also for prediction of organ failure at the early stage of pancreatitis to a high accuracy as compared to conventional CT systems for assessment of the condition of patients affected by pancreatitis. It can also be used to differentiate the severity of organ failure and the number of affected organs.