scholarly journals Pancreatic Perfusion CT in Early Stage of Severe Acute Pancreatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Yoshihisa Tsuji ◽  
Naoki Takahashi ◽  
Chiba Tsutomu
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Mortality Rates ◽  
Perfusion Ct ◽  
Clinical Usefulness ◽  
Systemic Complications ◽  
Pancreatic Perfusion ◽  
Local And Systemic Complications

Early intensive care for severe acute pancreatitis is essential for improving SAP mortality rates. However, intensive therapies for SAP are often delayed because there is no ideal way to accurately evaluate severity in the early stages. Currently, perfusion CT has been shown useful to predict prognosis of SAP in the early stage. In this presented paper, we would like to review the clinical usefulness and limitations of perfusion CT for evaluation of local and systemic complications in early stage of SAP.

scholarly journals Pancreatic perfusion CT in the early stage of severe acute pancreatitis

Suizo ◽  
2014 ◽  
Vol 29 (2) ◽  
pp. 178-182
Author(s):  
Yoshihisa TSUJI ◽  
Yuzo KODAMA ◽  
Tsukasa YOSHIDA ◽  
Tsutomu CHIBA
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Perfusion Ct ◽  
Pancreatic Perfusion

Sa1368 Prediction for Complications of Severe Acute Pancreatitis Using Perfusion CT in the Early Stage

2013 ◽  
Vol 144 (5) ◽  
pp. S-276 ◽  
Author(s):  
Yoshihisa Tsuji ◽  
Tsubasa Watanabe ◽  
Hiroshi Yamamoto ◽  
Tsutomu Chiba
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Perfusion Ct

“PERFUSION CT IN PREDICTING THE DEVELOPMENT OF PANCREATIC NECROSIS IN EARLY STAGE OF SEVERE ACUTE PANCREATITIS”

2021 ◽  
pp. 27-31
Author(s):  
Sayan Bhoumik ◽  
Alpana Manchanda ◽  
jyoti Kumar ◽  
Pawanindra Lal ◽  
Sushanto Neogi
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Perfusion Defect ◽  
Pancreatic Necrosis ◽  
Ct Perfusion ◽  
Early Stage ◽  
Perfusion Ct ◽  
Iodinated Contrast

PURPOSE: To evaluate the role of perfusion CT (PCT) scan in predicting the development of pancreatic necrosis (PN) in early stage of severe acute pancreatitis (SAP). MATERIALS AND METHODS: A total of 20 adult patients with a clinical diagnosis of SAP presenting within 72 hours of onset of symptoms with a positive SIRS criteria were included in the study. All the patients underwent PCT on a 128 slice MDCT scannerusing 40 ml of non-ionic iodinated contrast followed by post processing using vendor provided CT perfusion software whereby perfusion parameters were calculated. Perfusion defect (PD) was dened as pancreatic BF and/or BV qualitatively less than hepatic BF and/or BV respectively on the color coded maps. A follow up CECT abdomen was done after 2 weeks as a 'gold standard' to assess whether PN developed in the corresponding region of PD. RESULTS: 8 out of 20 patients developed perfusion defect (PD) on the PCT, of which 6 patients developed PN on the follow up scan. Patients who did not show any PD on the PCT (12 out of 20) did not develop necrosis on the follow up CECT. The sensitivity, specicity, PPV, NPV and accuracy of PCT in predicting necrosis was 100%, 85.71%, 75%, 100% and 90% respectively. The cut off values of pancreatic BF and BV in predicting the development of PN were 34.87 ml/100ml/min and 11.70ml/100ml respectively based on the ROC curve. CONCLUSION: PCT is a useful technique that can predict development of PN in the early stage of SAP so that early aggressive management can be initiated.

scholarly journals A Novel Nomogram for Predicting Survival in Patients with Severe Acute Pancreatitis: An Analysis Based on the Large MIMIC-III Clinical Database

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Didi Han ◽  
Fengshuo Xu ◽  
Chengzhuo Li ◽  
Luming Zhang ◽  
Rui Yang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Medical Information ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Mortality Rates ◽  
Training Cohort ◽  
Net Reclassification Improvement ◽  
Mimic Iii

Background. Severe acute pancreatitis (SAP) can cause various complications. Septic shock is a relatively common and serious complication that causes uncontrolled systemic inflammatory response syndrome, which is one of the main causes of death. This study aimed to develop a nomogram for predicting the overall survival of SAP patients during the initial 24 hours following admission. Materials and Methods. All the data utilized in this study were obtained from the MIMIC-III (Medical Information Mart for Intensive Care III) database. The data were analyzed using multivariate Cox regression, and the performance of the proposed nomogram was evaluated based on Harrell’s concordance index (C-index) and the area under the receiver operating characteristic curve (AUC). The clinical value of the prediction model was tested using decision-curve analysis (DCA). The primary outcomes were 28-day, 60-day, and 90-day mortality rates. Results. The 850 patients included in the analysis comprised 595 in the training cohort and 255 in the validation cohort. The training cohort consisted of 353 (59.3%) males and 242 (40.7%) females with SAP. Multivariate Cox regression showed that weight, sex, insurance status, explicit sepsis, SAPSII score, Elixhauser score, bilirubin, anion gap, creatinine, hematocrit, hemoglobin, RDW, SPO2, and respiratory rate were independent prognostic factors for the survival of SAP patients admitted to an intensive care unit. The predicted values were compared using C-indexes, calibration plots, integrated discrimination improvement, net reclassification improvement, and DCA. Conclusions. We have identified some important demographic and laboratory parameters related to the prognosis of patients with SAP and have used them to establish a more accurate and convenient nomogram for evaluating their 28-day, 60-day, and 90-day mortality rates.

scholarly journals A novel nomogram for predicting survival in patients with severe acute pancreatitis: an analysis based on the large MIMIC-III clinical database

2020 ◽  
Author(s):  
Di di Han ◽  
Shuo Feng Xu ◽  
Zhuo Cheng Li ◽  
Ming Lu Zhang ◽  
Rui Yang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Medical Information ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Mortality Rates ◽  
Training Cohort ◽  
Net Reclassification Improvement ◽  
Mimic Iii

Abstract Background Severe acute pancreatitis (SAP) can cause various complications. Septic shock is a relatively common and serious complication that causes uncontrolled systemic inflammatory response syndrome, which is one of the main causes of death. This study aimed to develop a nomogram for predicting the overall survival of SAP patients during the initial 24 hours following admission. Materials and Methods All data utilized in this study were obtained from the MIMIC-III (Medical Information Mart for Intensive Care III) database. The data were analyzed using multivariate Cox regression, and the performance of the proposed nomogram was evaluated based on Harrell’s concordance index (C-index) and the area under the receiver operating characteristic curve(AUC). The clinical value of the prediction model was tested using decision-curve analysis (DCA). The primary outcomes were 28-day,60-day, and 90-day mortality rates. Results The 850 patients included in the analysis comprised 595 in the training cohort and 255 in the validation cohort. The training cohort consisted of 353 (59.3%) males and 242 (40.7%) females with SAP. Multivariate Cox regression showed that weight, sex, insurance status, explicit sepsis, SAPSII score, Elixhauser score, bilirubin, anion gap, creatinine, hematocrit, hemoglobin, RDW, SpO 2 , and respiratory rate were independent prognostic factors for the survival of SAP patients admitted to an intensive care unit. The predicted values were compared using C-indexes, calibration plots, integrated discrimination improvement, net reclassification improvement, and DCA. Conclusions We have identified some important demographic and laboratory parameters related to the prognosis of patients with SAP, and have used them to establish a more accurate and convenient nomogram for evaluating their 28-day, 60-day, and 90-day all-cause mortality rates. The prognostic value of the novel nomogram is superior to that of the traditional SAPSII scoring system alone.

Perfusion CT: Can it predict the development of pancreatic necrosis in early stage of severe acute pancreatitis?

2014 ◽  
Vol 40 (3) ◽  
pp. 488-499 ◽  
Author(s):  
Ajay Kumar Yadav ◽  
Raju Sharma ◽  
Devasenathipathy Kandasamy ◽  
Ashu Seith Bhalla ◽  
Shivanand Gamanagatti ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Early Stage ◽  
Perfusion Ct

Clinical Profile and Outcomes in Patients with Acute Pancreatitis attending a Teaching Hospital at Gandaki Province, Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Age Groups ◽  
Data Entry ◽  
Kidney Injury ◽  
Severity Index ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Keywords Alcohol

Background: Acute pancreatitis (AP) is inflammatory process of pancreas presenting with acute abdominal pain.The majority of patients have mild disease. Some patients develop local and systemic complications with increased morbidity and mortality. This study was undertaken to describe the clinical profile and outcomes in patients with acute pancreatitis.   Methods:  A cross-sectional hospital based study comprising of 62 consecutive patients with acute pancreatitis were enrolled between Jan 2019 to August 2020. Clinical profile at admission, complications and clinical outcomes including mortality were studied. Patients were classified into mild, moderately severe and severe acute pancreatitis based on revised Atlanta classification and modified CT severity index.  Data entry was done in Statistical Packages for the Social Sciences version 20. Results: The mean age of study subjects was 44±10.87 years with 43 (56%) males and 19 (44%) females (M:F=2.1:1). The commonest etiology of pancreatitis was alcohol (53.2%) followed by biliary pancreatitis (37.1%)  The most common presentation was abdominal pain (100%). The most common complication was pancreatic necrosis (21%) followed by acute kidney injury (19.4%) and pleural effusion (17.3%). Majority( 72.6%) was mild and 17.7% had severe acute pancreatitis. Mortality was seen in 6.5% patients. Mortality was observed in patients with persistent complications, organ failure, low serum calcium and high modified CT severity index.   Conclusions: Alcohol and gallstones were the two main etiologies of acute pancreatitis and were common in males, and in middle age groups. Majority presented with mild severity. Mortality was observed in some patients with severe acute pancreatitis.   Keywords: alcohol; biliary; CT severity index; mortality; outcome; pancreatitis          

scholarly journals THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS

2016 ◽  
Vol 29 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Murilo Gamba BEDUSCHI ◽  
André Luiz Parizi MELLO ◽  
Bruno VON-MÜHLEN ◽  
Orli FRANZON
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Length Of Stay ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
High Specificity ◽  
Daily Practice ◽  
Severe Form ◽  
Inclusion Criteria ◽  
Positive Score

Background: About 20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Several studies suggested methods to identify patients that will progress more severely. However, most studies present problems when used on daily practice. Objective: To assess the efficacy of the PANC 3 score to predict acute pancreatitis severity and its relation to clinical outcome. Methods: Acute pancreatitis patients were assessed as to sex, age, body mass index (BMI), etiology of pancreatitis, intensive care need, length of stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined within the first 24 hours after diagnosis and compared to acute pancreatitis grade of the Revised Atlanta classification. Results: Out of 64 patients diagnosed with acute pancreatitis, 58 met the inclusion criteria. The PANC 3 score was positive in five cases (8.6%), pancreatitis progressed to a severe form in 10 cases (17.2%) and five patients (8.6%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 50%, specificity of 100%, accuracy of 91.4%, positive predictive value of 100% and negative predictive value of 90.6% in prediction of severe acute pancreatitis. Conclusion: The PANC 3 score is useful to assess acute pancreatitis because it is easy and quick to use, has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis.

Urinary nitrogen excretion at the early stage of severe acute pancreatitis

2020 ◽  
Vol 21 (4) ◽  
pp. 131-134
Author(s):  
O. G. Sivkov ◽  
◽  
A. O. Sivkov ◽  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Ideal Body Weight ◽  
Nitrogen Excretion ◽  
The Third ◽  
Ideal Body ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen ◽  
The Ideal

Aim. To study urinary nitrogen excretion at the early stage of severe acute pancreatitis. Materials and methods. Prospective, single-center, cohort study. Inclusion criteria: diagnosis of acute pancreatitis and presence of at least one of the predictors of severe course. Among all patients (n = 72), a cohort of patients with severe acute pancreatitis (n = 32) was allocated. Three groups were formed in it: the first one – all patients, the second one – survivors (n = 24), the third one – deceased (n = 8). Urinary nitrogen excretion was determined using the Deacon formula. Measurements were performed on the first, third and fifth days of the disease. Statistical processing of the material was carried out by the SPSS software package. The null hypothesis was rejected at p < 0.05. Results. In the first week of the disease in all groups, the maximum urinary nitrogen excretion occurs on the 3rd day. When comparing the results of the second and third groups, it was found that the urinary nitrogen excretion on the first and fifth days did not have a statistically significant difference between the groups (respectively, p = 0.138, p = 0.572), and the results of the third day have (p = 0.014). A similar pattern remains when recalculating the nitrogen loss in the urine to the ideal weight; for the third day, the differences between the second and third groups were statistically significant (p = 0.007). ROC analysis of urinary nitrogen excretion of the third day calculated to the ideal body weight showed an area under the curve of 0.813 (p < 0.009). The value at the cut-off point is defined as 0.65 g/kg/day. The sensitivity of the model was 0.75%, specificity – 0.83%. Conclusion. If in a patient with acute pancreatitis, there is urinary nitrogen excretion on the third day from the onset of the disease, calculated to an ideal body weight of ≥ 0.65 g/kg/day, an unfavorable outcome of the disease is predicted.

Sign in / Sign up

Export Citation Format

Share Document