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A Modified CT Severity Index for Evaluating Acute Pancreatitis: Improved Correlation with Patient Outcome

Koenraad J. Mortele1, Walter Wiesner1, Lisa Intriere1, Shridhar Shankar1, Kelly H. Zou1,2, Babek N. Kalantari1, Alex Perez3, Eric vanSonnenberg1, Pablo R. Ros1, Peter A. Banks3 and Stuart G. Silverman1

1 Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.
2 Department of Health Care Policy, Harvard Medical School, Boston, MA 02115.
3 Department of Medicine, Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.



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  		Fig. 1A. —74-year-old man with acute pancreatitis. Axial contrast-enhanced CT scan shows presence of bilateral pleural effusions.

 


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  		Fig. 1B. —74-year-old man with acute pancreatitis. Axial contrast-enhanced CT scan shows one fluid collection in anterior pararenal space and minimal necrosis (< 30%). Score was 5 (moderate pancreatitis) on currently accepted CT severity index and 8 (severe pancreatitis) on modified CT severity index.

 


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  		Fig. 2. —Graph shows correlation between length of hospital stay and CT severity index score for pancreatitis using currently accepted (represented by black bars) and modified (represented by white bars) CT severity indexes. Although significant correlation (p = 0.035) was seen between modified severity index score and length of hospital stay for all severity groups (mean, 3 days for mild pancreatitis, 8 days for moderate pancreatitis, and 12 days for severe pancreatitis), no significant correlation (p = 0.15) was seen between currently accepted index and length of hospital stay in moderate and severe pancreatitis groups (mean, 9 and 11 days, respectively).

 

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