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.	中華醫學會消化病學分會胰腺疾病學組, 中華胰腺病雜志編輯委員會, 中華消化雜志編輯委員會.中國急性胰腺炎診治指南(2013年, 上海).中華消化雜志, 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.	董樂妹, 洪萬東, 吳建勝, 等.APACHE-Ⅱ標準、Balthazar分級及胰腺外炎癥評分系統對急性胰腺炎預后的評估價值比較.中國實用內科雜志, 2009, 29(8):720-722.
18.	李崢艷, 張凌, 金濤, 等.CT評分與重癥急性胰腺炎合并急性腎損傷的相關性分析.四川大學學報:醫學版, 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, 洪軍波, 等.新亞特蘭大分類下不同評分標準預測急性胰腺炎預后的價值比較.中華內科雜志, 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.	吳文治, 劉景云, 洪萬東, 等.4項臨床評分系統對重癥急性胰腺炎預后評估的受試者工作特征曲線分析.醫學研究雜志, 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.	樂星華, 謝會忠.四種評分系統對重癥急性胰腺炎預后評估的價值.現代消化及介入診療, 2009, 14(3):186-187.
25.	劉曉穎, 陳爾真.新日本嚴重度評分評估重癥急性胰腺炎嚴重度及風險的價值.上海交通大學學報, 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. 中華醫學會消化病學分會胰腺疾病學組, 中華胰腺病雜志編輯委員會, 中華消化雜志編輯委員會.中國急性胰腺炎診治指南(2013年, 上海).中華消化雜志, 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. 董樂妹, 洪萬東, 吳建勝, 等.APACHE-Ⅱ標準、Balthazar分級及胰腺外炎癥評分系統對急性胰腺炎預后的評估價值比較.中國實用內科雜志, 2009, 29(8):720-722.
18. 李崢艷, 張凌, 金濤, 等.CT評分與重癥急性胰腺炎合并急性腎損傷的相關性分析.四川大學學報:醫學版, 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, 洪軍波, 等.新亞特蘭大分類下不同評分標準預測急性胰腺炎預后的價值比較.中華內科雜志, 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. 吳文治, 劉景云, 洪萬東, 等.4項臨床評分系統對重癥急性胰腺炎預后評估的受試者工作特征曲線分析.醫學研究雜志, 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. 樂星華, 謝會忠.四種評分系統對重癥急性胰腺炎預后評估的價值.現代消化及介入診療, 2009, 14(3):186-187.
25. 劉曉穎, 陳爾真.新日本嚴重度評分評估重癥急性胰腺炎嚴重度及風險的價值.上海交通大學學報, 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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