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Role of extrapancreatic necrosis volume in determining early prognosis in patients with acute pancreatitis

  • Special Section: Pancreatitis
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study aims to evaluate the capacity of the clinical and radiological findings and the extrapancreatic necrotic tissue volume in early (2–6 days) computerized tomography (CT) images of patients diagnosed with AP to predict reliably the temporary or permanent organ failure and other local or systemic complications due to pancreatitis.

Materials and methods

Adult patients who were diagnosed with AP based on Revised Atlanta classification and underwent abdomen CT scans between May 2015 and May 2018 were examined retrospectively. Extrapancreatic necrosis volume was compared to various clinical parameters that indicate the prognosis of AP such as C-reactive protein (CRP) at 48–72th h, organ failure, infection, requirement for percutaneous or surgical intervention, length of hospital stay, and mortality, and to various imaging-based scoring systems such as the computerized tomography severity index (CTSI) and the modified CTSI (mCTSI). The receiver operating characteristic (ROC) curve was used to estimate the optimal threshold for predicting clinical prognosis.

Results

Extrapancreatic necrosis volume had moderate positive correlation with length of hospital stay (p = 0.0001) and CRP (at 48–72th h) (p = 0.0001) and strong positive correlation with CTSI (p = 0.0001), mCTSI (p = 0.0001), and white blood cell count (p = 0.0001).

Conclusion

Extrapancreatic necrosis volume was found to be particularly better in predicting organ failure and infection compared to the imaging-based scoring systems (Balthazar, CTSI, and mCTSI) and the laboratory-based scoring systems (CRP at 48–72th h).

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Authors and Affiliations

  1. Department of Radiology, Akdeniz University School of Medicine, Antalya, Turkey

    İsa Çakar, Ayşe Keven & Süleyman Metin Çubuk

  2. Department of Internal Medicine, Akdeniz University School of Medicine, Antalya, Turkey

    Esma Eseroğlu

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  1. İsa Çakar
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  2. Ayşe Keven
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  4. Süleyman Metin Çubuk
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Correspondence to Ayşe Keven.

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Çakar, İ., Keven, A., Eseroğlu, E. et al. Role of extrapancreatic necrosis volume in determining early prognosis in patients with acute pancreatitis. Abdom Radiol 45, 1507–1516 (2020). https://doi.org/10.1007/s00261-019-02188-9

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