Effects of early contrast-enhanced computed tomography on clinical course and complications in patients with acute pancreatitis

• Published in: Zeitschrift fur Gastroenterologie Vol. 54; no. 7; p. 642
• Main Authors: Demir, M, Foerster, U, Hoffmann, V, Pelc, A, Schreiter, I, Chang, D-H, Krug, B, Christ, H, Steffen, H M
• Format: Journal Article
• Language: English
• Published: Germany 01.07.2016
• Subjects: Acute Disease; Acute Kidney Injury - diagnosis; Acute Kidney Injury - mortality; Adult; Aged; Aged, 80 and over; Contrast Media; Disease Progression; Early Diagnosis; Female; Germany - epidemiology; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Pancreatectomy - mortality; Pancreatectomy - utilization; Pancreatitis - diagnostic imaging; Pancreatitis - mortality; Pancreatitis - surgery; Reproducibility of Results; Respiratory Insufficiency - diagnosis; Respiratory Insufficiency - mortality; Retrospective Studies; Risk Factors; Sensitivity and Specificity; Survival Rate; Tomography, X-Ray Computed - utilization; Young Adult
• ISSN: 1439-7803
• DOI: 10.1055/s-0042-101961

To investigate the effect of an early contrast-enhanced computed tomography (CECT) on clinical course and complications of acute pancreatitis (AP). 58 patients with AP who had at least one CECT examination were analyzed retrospectively. Laboratory as well as clinical data, and results from the assessment of disease severity (CT severity index (CTSI) and its modified (MCTSI) version) were analyzed. The primary endpoint was the development of severe complications, defined as death, respiratory failure, acute renal failure, and the need for invasive interventions. Patients were divided into two groups: an early group (CECT within the first 48 h after the onset of symptoms, n = 32) and a late group (CECT > 48 h after the onset of symptoms, n = 26). Multivariate regression analysis was performed to identify risk factors for severe complications. There were no statistically significant differences between both groups concerning baseline characteristics, CTSI, and MCTSI. Complications occurred more often in the early CECT group (p = 0.008). Multivariate logistic regression analysis identified an early CECT and a severe MCTSI as independent risk factors for the occurrence of severe complications (p = 0.02 and p = 0.002, respectively). CECT performed within the first 48 h after the onset of symptoms is associated with an unfavorable outcome in AP.