Predictive value of CT evaluation of fatty liver for the severity of acute pancreatitis / 中国医师进修杂志

ABSTRACT

Objective@#To investigate the predictive value of CT evaluation of fatty liver for the severity of acute pancreatitis(AP).@*Methods@#The clinical and imaging data of 325 patients with AP from January 2013 to December 2017 were retrospectively analyzed. The demographic characteristics, etiological types, AP severity classification, persistent organ failure and death were collected. According to the ratio of the CT value of the liver and spleen (CT valueratio), whether the patients had fatty liver and the severity of fatty liver were determined. The incidence of persistent organ failure and mortality in AP patients with or without fatty liver and between the different severity grades of fatty liver were compared. Univariate and multivariate Logistic regression analysis was used to assess the independent risk factors for persistent organ failure in AP.@*Results@#Among the 325 AP patients, 86 (26.5%) patients were in line with the CT diagnostic criteria for fatty liver and 239 (73.5%) patients did not meet the CT diagnostic criteria of fatty liver. The incidence of persistent organ failure in AP patients with fatty liver (CT valueratio<1.0) was significantly higher than that without fatty liver (CT valueratio=1.0)17.4%(15/86) vs. 7.5%(18/239), P<0.05. The rate of persistent organ failure in AP patients increased proportionally with the severity grades of fatty liver [7.5% in patients without fatty liver, 7.5%(18/239) in mild (0.7<CT valueratio<1.0), 18.5%(5/27) in moderate (0.5<CT valueratio ≤ 0.7), and 7/19 in severe (CT valueratio ≤ 0.5) fatty liver], P<0.05. Single factor analysis showed that sex, body mass index (BMI, ≥ 25 kg/m2), etiological type, combined fatty liver were associated with persistent organ failure in AP (P<0.05 or<0.01). Multiple factor Logistic regression analysis showed that the elderly (≥60 years old), high BMI (≥ 25 kg/m2) and combined fatty liver were independent risk factors for persistent organ failure in AP (P<0.05 or<0.01).@*Conclusions@#Assessment of fatty liver and its severity in AP patients by CT is valuable to predict the risk of persistent organ failure.