Pleural effusion volume in patients with acute pancreatitis: a retrospective study from three acute pancreatitis centers

Gaowu Yan,Hongwei Li,Anup Bhetuwal,Morgan A Mcclure,Yongmei Li,Guoqing Yang,Yong Li,Linwei Zhao,Xiaoping Fan

doi:10.1080/07853890.2021.1998594

Abstract

Objective To assess the value of pleural effusion volume (PEV) quantified on chest computed tomography (CT) in patients with early stage acute pancreatitis (AP). Methods Data of PEV, and C-reactive protein (CRP) levels as well as Ranson, bedside index of severity in acute pancreatitis (BISAP), Marshall, acute physiology and chronic health evaluation II (APACHE II), CT severity index (CTSI), and extra-pancreatic inflammation on computed tomography (EPIC) scores in patients with AP were collected. Duration of hospitalization, severity of AP, infection, procedure, intensive care unit (ICU) admission, organ failure, or death were included as the outcome parameters. Results In 465 patients, the mean PEV was 98.8 ± 113.2 mL. PEV showed strong and significant correlations with the CRP levels, duration of hospitalization as well as the Ranson, BISAP, Marshall, APACHE II, CTSI, and EPIC scores (p < .05). PEV demonstrated significant accuracy in predicting severity, infection, procedure, ICU admission, organ failure, and death (p < .05). Conclusion PEV quantified on chest CT positively associated with the duration of hospitalization, CRP levels, Ranson, BISAP, Marshall, APACHE II, CTSI, and EPIC scores. It can be a reliable radiologic biomarker in predicting severity and clinical outcomes of AP. KEY MESSAGES Pleural effusion is a common chest finding in patients with acute pancreatitis. Pleural effusion volume quantified on chest CT examination positively associated with the duration of hospitalization, CRP level, as well as Ranson, BISAP, Marshall, APACHE II, CTSI, and EPIC scoring systems. Pleural effusion volume can be a reliable radiologic biomarker in the prediction of severity and clinical outcomes of acute pancreatitis.

Highlights

Acute pancreatitis (AP) is one of the most common acute abdominal diseases in the clinical practice [1,2]
Pleural effusion volume quantified on chest computed tomography (CT) examination positively associated with the duration of hospitalization, C-reactive protein (CRP) level, as well as Ranson, bedside index of severity in acute pancreatitis (BISAP), Marshall, APACHE II, CT severity index (CTSI), and extra-pancreatic inflammation on computed tomography (EPIC) scoring systems
AP: acute pancreatitis; PEV: pleural effusion volume; CRP: C-reactive protein; BISAP: bedside index for severity in acute pancreatitis; APACHE II: acute physiology and chronic health evaluation II; CTSI: computed tomography severity index; EPIC: extrapancreatic inflammation on computed tomography; ICU: intensive care unit; AUC: area under the receiver operating characteristic curve; 95% CI: 95% confidence interval

Summary

Introduction

Acute pancreatitis (AP) is one of the most common acute abdominal diseases in the clinical practice [1,2] It can be induced by various causes with the initial event being the activation of the pancreatic enzyme within the pancreas. In 1992, a widely accepted Atlanta classification divided AP into two subtypes, i.e. mild AP (associated with minimal organ dysfunction and an uneventful recovery lacking the features of severe pancreatitis) and severe AP (associated with organ failure and/or local complications, such as necrosis, abscess, or pseudocyst) [8]. Since it was introduced, CONTACT Yongmei Li 400016, China

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