ABSTRACT
Objective: To determine the diagnostic accuracy of modified CT severity index in assessing the severe acute pancreatitis keeping APACHE II as gold standard
Study Design: Cross-sectional [validation] study
Place and Duration of Study: Department of Radiology, Allied Hospital, Faisalabad, from February to August 2014
Methodology: A total of 120 patients of either gender aged 20-60 years with epigastric pain radiating to back and having sonographic findings [decreased or heterogeneous pancreatic echogenicity, pancreatic enlargement, peripancreatic fluid collection], supportive of acute pancreatitis were taken. CT with intravenous contrast was performed on 128-slice scanner within 24 hours of presentation. Slice thickness was 3 mm in region of pancreas. Modified CT severity index was calculated. Score above 5 was graded as severe pancreatitis. APACHE II score of >11 considered as gold standard was also calculated within 24 hours of admission
Results: Mean age of the patients was 39.03 +/- 8.71 years. Most of the patients were females 73 [60.8%]. Out of 120 patients, 43 [35.83%] patients had severe acute pancreatitis. Sensitivity, specificity, positive predictive value and negative predictive value of modified CT severity index in assessing the severe acute pancreatitis were 100%, 87%, 81.13% and 100%, respectively. The diagnostic accuracy was yielded as 91.67% considered APACHE II as gold standard
Conclusion: Modified CT severity index had high diagnostic accuracy in assessment of severe acute pancreatitis and can be used reliably in early prediction of complications of severe acute pancreatitis