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Balthazar computed tomography severity index is superior to Ranson criteria and APACHE Ⅱ scoring system in predicting acute pancreatitis outcome

查看全文 作　　者：Ting-Kai [1]Leung;Chi-Ming [1]Lee;Shyr-Yi [2]Lin;Hsin-Chi [1]Chen;Hung-Jung [1]Wang;Li-Kuo [1]Shen;Ya-Yen [1]Chen 高影响力作者 机构地区：[1]Department of Diagnostic Radiology, Taipei Medical University Hospital, Taipei, Taiwan,China;[2]Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, China高影响力机构 出　　处：《World Journal of Gastroenterology》索引2005年第11卷第38期,共4页高影响力期刊 摘　　要：AIM: Acute pancreatitis (AP) is a process with variable involvement of regional tissues or organ systems.Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ) systems and Balthazar computed tomography severity index (CTSI).The purpose of this review study was to assess the accuracy of CTSI, Ranson score, and APACHE Ⅱ score in course and outcome prediction of AP.METHODS: We reviewed 121 patients who underwent helical CT within 48 h after onset of symptoms of a first episode of AP between 1999 and 2003. Fourteen inappropriate subjects were excluded; we reviewed the 107 contrastenhanced CT images to calculate the CTSI. We also reviewed their Ranson and APACHE Ⅱ score. In addition, complications,duration of hospitalization, mortality rate, and other pathology history also were our comparison parameters.RESULTS: We classified 85 patients (79%) as having mild AP (CTSI <5) and 22 patients (21%) as having severe AP (CTSI ≥5). In mild group, the mean APACHE Ⅱ score and Ranson score was 8.6±1.9 and 2.4±1.2, and those of severe group was 10.2±2.1 and 3.1±0.8, respectively. The most common complication was pseudocyst and abscess and it presented in 21 (20%) patients and their CTSI was 5.9±1.4. A CTSI ≥5 significantly correlated with death,complication present, and prolonged length of stay.Patients with a CTSI ≥5 were 15 times to die than those CTSI <5, and the prolonged length of stay and complications present were 17 times and 8 times than that in CTSI <5,respectively.CONCLUSION: CTSI is a useful tool in assessing the severity and outcome of AP and the CTSI ≥5 is an index in our study. Although Ranson score and APACHE Ⅱ score also are choices to be the predictors for complications,mortality and the length of stay of AP, the sensitivity of them are lower than CTSI. 关 键 词：X线检查 慢性健康评估Ⅱ 急性胰腺炎 临床表现 检查方法
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