Radiologic imaging utilization in the diagnosis of acute pancreatitis

Abstract

Background and objectives: Acute pancreatitis is a major cause of hospitalizations in the United States. Imaging is often unwarranted in early, uncomplicated pancreatitis however can prove to be useful in specific clinical scenarios. This study aimed to investigate whether our institution overutilizes abdominal imaging in diagnosis of pancreatitis. Methods: Patients with acute pancreatitis admitted to our institution between 2015 and 2020 were identified using the International Classification of Diseases diagnosis codes. A total of 669 patients met the criteria for acute pancreatitis according to the revised Atlanta Classification. The data was presented using frequencies and percentages and patients with abdominal imaging were compared to those without. Mann Whitney U test and chi-square test were used to compare continuous and categorical variables respectively. Univariable and multivariable regression analysis was used to analyze factors associated with the performance of abdominal imaging. Results: Our results found that 495 patients (74%) had an abdominal computerized tomography (CT) scan, while 363 patients (52%) had an abdominal ultrasound. More than half of the patients who already met 2 out of 3 clinical and laboratory criteria of the revised Atlanta classification still underwent abdominal imaging, even though it was not necessary. However, we found no significant difference in outcomes between patients who underwent imaging and those who did not, including the need for mechanical ventilation, intensive care unit admission, and inpatient death. Conclusion: A significant number of patients admitted for acute pancreatitis undergo abdominal imaging even after fulfilling clinical and laboratory diagnostic criteria.