The Comparison of Different CT Scoring Systems in Early Predicting of Organ Dysfunction in Acute Pancreatitis Based on Revised Atlanta Classification_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENChen-yang , WANGQi-yan , WUMing-peng , CHENJie , HUANGZi-xing ,  SONGBin

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Acute pancreatitis; Atlanta classification; Computed tomography scoring system; Clinical scoring system

DOI：

10.7507/1007-9424.20150032

Video：

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Objective To compare the predictive value of Balthazar computed tomography severity index (CTSI), Modified computed tomography severity index (MCTSI) and extrapancreatic inflammation on CT (EPIC) in patients diagnosed as acute pancreatitis with organ dysfunction based on the revised Atlanta classification. Methods The clinical data of patients diagnosed as acute pancreatitis from December 2013 to January 2014 were analyzed retrospectively. Four imaging score systems (CTSI, MCTSI, EPIC, and local complications) and two clinical score systems were assessed with ROC and AUC. Results ①There were no statistical significances in the age, gender, time after onset of symptoms to CT scanning in 54 patients (P > 0.05).②CTSI, MCTSI, EPIC, and local complications were good independent predictors of organ dysfunction in the early phase (P < 0.05), while BISAP and NJSS were not (P > 0.05). Conclusion CT scoring systems can accurately evaluate organ dysfunction of acute pancreatitis in the early phase.

Citation： CHENChen-yang, WANGQi-yan, WUMing-peng, CHENJie, HUANGZi-xing, SONGBin. The Comparison of Different CT Scoring Systems in Early Predicting of Organ Dysfunction in Acute Pancreatitis Based on Revised Atlanta Classification. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(1): 117-120. doi: 10.7507/1007-9424.20150032 Copy

1.	McKay CJ, Imrie CW.The continuing challenge of early mortality in acute pancreatitis.Br J Surg, 2004, 91(10):1243-1244.
2.	Charikleia T, Dimitrios L, Petros M, et al.Computed tomography versus acute physiology and Chronic health evaluationⅡscore in predicting severity of acute pancreatitis.Pancreas, 2007, 35(3):238-242.
3.	King NKK, Powell JJ, Redhead D, et al.A simplified method for computed tomographic estimation of prognosis in acute pancreatitis.Scand J Gastroenterol, 2003, 38:433-436.
4.	Sun JK, Li WQ, Ni HB, et al.Modified gastrointestinal failure score for patients with severe acute pancreatitis.Surg Tody, 2013, 43(5):506-513.
5.	Bollen TL, Singh VK, Maurer R, et al.A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis.Am J Gastroenterol, 2011, 107(4):612-619.
6.	Banks PA, Bollen TL, Dervenis C, et al.Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus.Gut, 2012, 62(1):102-111.
7.	Perez A, Whang EE, Brooks DC, et al.Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis? Pancreas, 2002, 25(3):229-233.
8.	Wu BU, Johannes RS, Sun X, et al.The early prediction of mortality in acute pancreatitis:a large population-based study.Gut, 2008, 57(12):1698-1703.
9.	Ueda T, Takeyama Y, Yasuda T, et al.Utility of the new Japanese severity score and indications for special therapies in acute pancreatitis.J Gastroenterol, 2009, 44(5):453-459.
10.	Balthazar EJ, Ranson JH, Naidich DP, et al.Acute pancreatitis:prognostic value of CT.Radiology, 1985, 156(3):767-772.
11.	Balthazar EJ, Robinson DL, Megibow AJ, et al.Acute pancreatitis:value of CT in establishing prognosis.Radiology, 1990, 174(2):331-336.
12.	De Waele JJ, Delrue L, Hoste EA, et al.Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis:evaluation of a new scoring system.Pancreas, 2007, 34(2):185-190.
13.	中华医学会消化病学分会胰腺疾病学组, 中华胰腺病杂志编辑委员会, 中华消化杂志编辑委员会.中国急性胰腺炎诊治指南(2013年, 上海).中华消化杂志, 2013, 33(4):217-222.
14.	Vege SS, Gardner TB, Chari ST, et al.Low mortality and high morbidity in severe acute pancreatitis without organ dysfunction:a case for revising the Atlanta classification to include "moderately severe acute pancreatitis".Am J Gastroenterol, 2009, 104(3):710-715.
15.	Casas JD, Diaz R, Valderas G, et al.Prognostic value of CT in the early assessment of patients with acute pancreatitis.AJR Am J Roentgenol, 2004, 182(3):569-574.
16.	Byung GK, Myung HN, Choong HR, et al.A comparison of the BISAP score and serum procalcitonin for predicting the severity of acute pancreatitis.Korean J Intern Med, 2013, 28(3):322-329.
17.	董乐妹, 洪万东, 吴建胜, 等.APACHE-Ⅱ标准、Balthazar分级及胰腺外炎症评分系统对急性胰腺炎预后的评估价值比较.中国实用内科杂志, 2009, 29(8):720-722.
18.	李峥艳, 张凌, 金涛, 等.CT评分与重症急性胰腺炎合并急性肾损伤的相关性分析.四川大学学报:医学版, 2011, 42(5):695-698.
19.	Papachristou GI, Muddana V, Yadav D, et al.Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ dysfun ction, complications, and mortality in acute pancreatitis.Am J Gastroenterol, 2010, 105(2):435-441.
20.	汪安江, 徐思, 洪军波, 等.新亚特兰大分类下不同评分标准预测急性胰腺炎预后的价值比较.中华内科杂志, 2013, 52(8):668-671.
21.	Khanna AK, Meher S, Prakash S, et al.Comparison of ranson, glasgow, MOSS, SIRS, BISAP, APACHE-Ⅱ, CTSI scores, IL-6, CRP, and procalcitonin in predicting severity, organ failure, pancreatic necrosis, and mortality in acute pancreatitis.HPB Surgery, 2013, 2013:367581.
22.	吴文治, 刘景云, 洪万东, 等.4项临床评分系统对重症急性胰腺炎预后评估的受试者工作特征曲线分析.医学研究杂志, 2013, 42(2):144-147.
23.	Hirota M, Takada T, Kawarada Y, et al.JPN Guidelines for the management of acute pancreatitis:severity assessment of acute pancreatitis.Hepatobiliary Pancreat Surg, 2006, 13(1):33-41.
24.	乐星华, 谢会忠.四种评分系统对重症急性胰腺炎预后评估的价值.现代消化及介入诊疗, 2009, 14(3):186-187.
25.	刘晓颖, 陈尔真.新日本严重度评分评估重症急性胰腺炎严重度及风险的价值.上海交通大学学报, 2012, 32(3):344-347.

1. McKay CJ, Imrie CW.The continuing challenge of early mortality in acute pancreatitis.Br J Surg, 2004, 91(10):1243-1244.
2. Charikleia T, Dimitrios L, Petros M, et al.Computed tomography versus acute physiology and Chronic health evaluationⅡscore in predicting severity of acute pancreatitis.Pancreas, 2007, 35(3):238-242.
3. King NKK, Powell JJ, Redhead D, et al.A simplified method for computed tomographic estimation of prognosis in acute pancreatitis.Scand J Gastroenterol, 2003, 38:433-436.
4. Sun JK, Li WQ, Ni HB, et al.Modified gastrointestinal failure score for patients with severe acute pancreatitis.Surg Tody, 2013, 43(5):506-513.
5. Bollen TL, Singh VK, Maurer R, et al.A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis.Am J Gastroenterol, 2011, 107(4):612-619.
6. Banks PA, Bollen TL, Dervenis C, et al.Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus.Gut, 2012, 62(1):102-111.
7. Perez A, Whang EE, Brooks DC, et al.Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis? Pancreas, 2002, 25(3):229-233.
8. Wu BU, Johannes RS, Sun X, et al.The early prediction of mortality in acute pancreatitis:a large population-based study.Gut, 2008, 57(12):1698-1703.
9. Ueda T, Takeyama Y, Yasuda T, et al.Utility of the new Japanese severity score and indications for special therapies in acute pancreatitis.J Gastroenterol, 2009, 44(5):453-459.
10. Balthazar EJ, Ranson JH, Naidich DP, et al.Acute pancreatitis:prognostic value of CT.Radiology, 1985, 156(3):767-772.
11. Balthazar EJ, Robinson DL, Megibow AJ, et al.Acute pancreatitis:value of CT in establishing prognosis.Radiology, 1990, 174(2):331-336.
12. De Waele JJ, Delrue L, Hoste EA, et al.Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis:evaluation of a new scoring system.Pancreas, 2007, 34(2):185-190.
13. 中华医学会消化病学分会胰腺疾病学组, 中华胰腺病杂志编辑委员会, 中华消化杂志编辑委员会.中国急性胰腺炎诊治指南(2013年, 上海).中华消化杂志, 2013, 33(4):217-222.
14. Vege SS, Gardner TB, Chari ST, et al.Low mortality and high morbidity in severe acute pancreatitis without organ dysfunction:a case for revising the Atlanta classification to include "moderately severe acute pancreatitis".Am J Gastroenterol, 2009, 104(3):710-715.
15. Casas JD, Diaz R, Valderas G, et al.Prognostic value of CT in the early assessment of patients with acute pancreatitis.AJR Am J Roentgenol, 2004, 182(3):569-574.
16. Byung GK, Myung HN, Choong HR, et al.A comparison of the BISAP score and serum procalcitonin for predicting the severity of acute pancreatitis.Korean J Intern Med, 2013, 28(3):322-329.
17. 董乐妹, 洪万东, 吴建胜, 等.APACHE-Ⅱ标准、Balthazar分级及胰腺外炎症评分系统对急性胰腺炎预后的评估价值比较.中国实用内科杂志, 2009, 29(8):720-722.
18. 李峥艳, 张凌, 金涛, 等.CT评分与重症急性胰腺炎合并急性肾损伤的相关性分析.四川大学学报:医学版, 2011, 42(5):695-698.
19. Papachristou GI, Muddana V, Yadav D, et al.Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ dysfun ction, complications, and mortality in acute pancreatitis.Am J Gastroenterol, 2010, 105(2):435-441.
20. 汪安江, 徐思, 洪军波, 等.新亚特兰大分类下不同评分标准预测急性胰腺炎预后的价值比较.中华内科杂志, 2013, 52(8):668-671.
21. Khanna AK, Meher S, Prakash S, et al.Comparison of ranson, glasgow, MOSS, SIRS, BISAP, APACHE-Ⅱ, CTSI scores, IL-6, CRP, and procalcitonin in predicting severity, organ failure, pancreatic necrosis, and mortality in acute pancreatitis.HPB Surgery, 2013, 2013:367581.
22. 吴文治, 刘景云, 洪万东, 等.4项临床评分系统对重症急性胰腺炎预后评估的受试者工作特征曲线分析.医学研究杂志, 2013, 42(2):144-147.
23. Hirota M, Takada T, Kawarada Y, et al.JPN Guidelines for the management of acute pancreatitis:severity assessment of acute pancreatitis.Hepatobiliary Pancreat Surg, 2006, 13(1):33-41.
24. 乐星华, 谢会忠.四种评分系统对重症急性胰腺炎预后评估的价值.现代消化及介入诊疗, 2009, 14(3):186-187.
25. 刘晓颖, 陈尔真.新日本严重度评分评估重症急性胰腺炎严重度及风险的价值.上海交通大学学报, 2012, 32(3):344-347.

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The Comparison of Different CT Scoring Systems in Early Predicting of Organ Dysfunction in Acute Pancreatitis Based on Revised Atlanta Classification

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