Modified Computed Tomography Severity Index and its relation to prognosis of acute pancreatitis at a tertiary care hospital of Peshawar

Abstract

Introduction: Acute pancreatitis is diagnosed by medical history, physical examination, and typically a blood test for the pancreatic enzymes amylase and/or lipase, whose levels are usually elevated to 3 times beyond normal values. Despite this, if the diagnosis remains uncertain, abdominal Computed Tomography (CT) is performed.

Objective: To evaluate the modified computed tomography severity index (MCTSI) and its relation to prognosis in acute pancreatitis.

Materials & Methods: A cross sectional study was conducted in January 2019 based on retrieved hospital data of the Department of Surgery, Rehman Medical Institute, Peshawar for the years 2016 to 2018, on all patients diagnosed as first time acute pancreatitis who underwent spiral CT with intravenous contrast within 4 days of onset of symptoms. Descriptive data analysis was carried out using SPSS 22.0.

Results: The MCTSI scoring showed that the age group 60 and above were affected by acute pancreatitis and its complications and gender wise in that age group female were affected the most. Results showed that the score <6 showed good prognosis with very little mortality rate and that also depending on what kind of pancreatic and extra pancreatic complication they developed and also >6 had poor prognosis and the mortality rate was as high as 30%.

Conclusion: The Modified CT Severity Index is a simpler scoring tool, in this study, it had a stronger statistical correlation with the prognosis of acute pancreatitis.