This study was conducted to assess the correlation with patient outcome and interobserver variability of a modified CT severity index in the evaluation of patients with acute pancreatitis compared with the currently accepted CT severity index.
Material and Methods: This is a prospective study, conducted from January 2019 to December 2019, in the Department of Radio Diagnosis, Noor Hospital, Indian Institute of Medical Science and Research (IIMS&R), Warudi, Badnapur. A total of 63 patients referred from the Department of Medicine and Department of Surgery, IIMS & R presented with the chief complaint of epigastric pain, nausea and vomiting and CECT abdomen were suggestive of acute pancreatitis were included in this study.
Assessment of Severity: Assessment of severity of acute pancreatitis was done in all cases by Balthazar CTSI scoring and Mortele Modified CTSI scoring.
Results: In our study total 63 cases of acute pancreatitis cases were included in the study. These patients underwent CT abdomen and pelvis, later images were reviewed by radiologist. The maximum patients were in the age group of 21 to 40 years [n=31 (49.2%)]. We found that acute pancreatitis was found three times more common in males than in females. Cholelithiasis was found to be most common aetiological factor for acute pancreatitis in 46% cases followed by alcoholic pancreatitis was seen in 28.5% of cases. Majority of the cases were categorized as mild pancreatitis according Balthazar CTSI score. Majority of the cases were categorized as severe pancreatitis using the Modified Mortele CTS score. Whereas, organ failure, moderate and severe category in modified Mortele CTSI, mild, moderate, severe category in Balthazar CTSI.
Conclusion: In conclusion CECT was found to be an excellent imaging modality for diagnosis, establishing the extent of disease process and in grading its severity. The Modified CT Severity Index is a simpler scoring tool and more accurate than the Balthazar CT Severity Index. In this study, it had a stronger statistical correlation with the clinical outcome, be it the length of hospital stay, development of infection and occurrence of organ failure. It could also predict the need for interventional procedures.