Predictive value of modified CT severity index and CT severity index for severity and prognosis of acute pancreatitis

Abstract

Objective To compare the predictive value of CT severity index (CTSI) and modified CT severity index (MCTSI) for the severity and prognosis of acute pancreatitis (AP). Methods The clinical data of 72 patients with AP were retrospectively analyzed. The consistency between MCTSI, CTSI and revised Atlanta classification of AP-2012 was respectively compared by the Kappa test. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the MCTSI and CTSI in differentiating severe acute pancreatitis (SAP) were calculated. The predictive value of MCTSI and CTSI for SAP and mortality was respectively analyzed by receiver operating characteristic (ROC) curve, and the area under the curve (AUC) was respectively calculated. Results The MCTSI and CTSI showed good agreement with the revised Atlanta classification of AP-2012 (the Kappa statistic was 0.653 and 0.656 respectively). The sensitivity, specificity, PPV and NPV of MCTSI were 90.0% (18/20), 86.5% (45/52), 72.0% (18/25) and 95.7% (45/47) respectively; and those of CTSI were 50.0% (10/20), 96.2% (50/52), 83.3% (10/12) and 83.3% (50/60) respectively. The AUC of MCTSI for predicting SAP and mortality were 0.932 and 0.913 respectively, and of CTSI were 0.908 and 0.874 respectively. Conclusions The MCTSI and CTSI have a similar and good consistency in predicting severity of AP. However, the MCTSI shows more sensitive and accurate in predicting SAP and prognosis. Key words: Pancreatitis; Tomography, X-ray computed; Prognosis; Retrospective studies