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KMID : 0371320010610040425
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Journal of the Korean Surgical Society
2001 Volume.61 No. 4 p.425 ~ p.433
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Comparison of Multiple Scoring Systems and CT Severity Index for Systemic and Local Complications of Acute Pancreatitis
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Kim Nam-Ryeol
Chung Hwan-Hoon
Kang Seok-Hyung
Min Youn-Ki
Cho Min-Young
Seo Seong-Ok
Kim Young-Chul
Whang Jeong-Woong
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Abstract
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Purpose : The progression of mortality of acute pancreatitis occurs in two different phases. One occurs earlier in the course of the disease and results from systemic complications such as renal failure and ARDS. Another occurs later and
results
from local complications such as a pancreatic abscess, an infected phlegmon or a pseudocyst. The values of the Ranson score, the Glasgow (Imrie) score, the Acute Physiology and the Chronic Health Evaluation (APACHE Ⅱ) score and computerized
tomography
severity index (CTSI) of Balthazar were compared in an evaluation and monitoring of acute pancreatitis, in which we mainly predicted the occurrence of systemic and local complications of the attacks in 31 patients.
Methods : Between January 1997 and December 1999, 31 patients who had a clinical diagnosis of acute pancreatitis which was supported by the presence of a serum amylase that exceeded 200 IU/ℓ and the presenting clinical symptoms were
included in
this study. We reviewed their medical records and their abdominal CT imaging scans. We calculated the CTSI based on the CT imaging findings with the assistance of a radiologist.
Results : Among the 31 patients, systemic complications had developed in 10 patients and local complications had occurred in 12 patients. In all of the scoring systems including the CTSI, the mean scores of the group who had systemic
complications were higher than the group with no complication. The accuracy of the Glasgow score (≥4) and the APACHE Ⅱ score (48 hours after admission, ≥10) was greater than that of the others. However, only the CTSI was accurately predicted
the
occurrence of local complications.
Conclusion : These results suggest that CTSI should be considered as being a predicting factor when it is combined with multiple scoring systems such as the Ranson score, the Glasgow score or the APACHE Ⅱ score in order to obtain accurate
prediction of the prognosis and the mortality rate in acute pancreatitis.
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KEYWORD
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