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Scand J Gastroenterol. 2018 Jan;53(1):88-93. doi: 10.1080/00365521.2017.1383510. Epub 2017 Oct 11.

Persistent SIRS and acute fluid collections are associated with increased CT scanning in acute interstitial pancreatitis.

Author information

1
a Division of Gastroenterology , Johns Hopkins Medical Institutions , Baltimore , MD , USA.
2
b Division of Surgical Oncology, Department of Surgery , Johns Hopkins Medical Institutions , Baltimore , MD , USA.
3
c Pancreatitis Center, Johns Hopkins Medical Institutions , Baltimore , MD , USA.
4
d Department of Radiology , Johns Hopkins Medical Institutions , Baltimore , MD , USA.

Abstract

BACKGROUND:

The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine.

AIM:

To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP).

METHODS:

Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI) ≤ 3 on a CT obtained within 48 h of presentation were included.

RESULTS:

A total of 229 patients were included, of whom 206 (90%) had a single CT and 23 (10%) had >1 CT during the first week of hospitalization. Patients undergoing >1 CT had significantly higher rates of acute fluid collection (AFC), persistent SIRS, opioid use ≥4 days, and persistent organ failure compared to those undergoing 1 CT (p < .05 for all). On multivariable analysis, only persistent SIRS (OR = 3.6, 95% CI 1.4-9.6, p = .01) and an AFC on initial CT (OR = 3.5, 95% CI 1.4-9, p = .009) were independently associated with obtaining >1 CT.

CONCLUSION:

An AFC on initial CT and persistent SIRS are associated with increased CT imaging in AIP patients. However, these additional CT scans did not change clinical management.

KEYWORDS:

Acute pancreatitis; CT scans; acute fluid collection; persistent SIRS

PMID:
29017354
DOI:
10.1080/00365521.2017.1383510
[Indexed for MEDLINE]

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