Acute pancreatitis: prognostic value of CT.

Balthazar, Emil J.; Ranson, John H. C.; Naidich, David P.; Megibow, Alec J.; Caccavale, Rosalba; Cooper, Michol

doi:10.1148/radiology.156.3.4023241

Cited by 548 publications

(269 citation statements)

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“…Fluid located in the posterior pararenal or perirenal space was graded higher because this is considered an uncommon finding (19). It is interesting that, although pancreatic glandular necrosis has long been considered a very important radiologic prognostic sign (5,20,21), this input did not improve the performance of the ANN. This is likely because substantial necrosis (ie, Ͼ30%) will be seen in only a small number of consecutive patients with acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Outcome Analysis of Patients with Acute Pancreatitis by Using an Artificial Neural Network

Keogan

Freed

et al. 2002

Academic Radiology

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Rationale and Objectives. The authors performed this study to evaluate the ability of an artificial neural network (ANN) that uses radiologic and laboratory data to predict the outcome in patients with acute pancreatitis. Materials andMethods. An ANN was constructed with data from 92 patients with acute pancreatitis who underwent computed tomography (CT). Input nodes included clinical, laboratory, and CT data. The ANN was trained and tested by using a round-robin technique, and the performance of the ANN was compared with that of linear discriminant analysis and Ranson and Balthazar grading systems by using receiver operating characteristic analysis. The length of hospital stay was used as an outcome measure.Results. Hospital stay ranged from 0 to 45 days, with a mean of 8.4 days. The hospital stay was shorter than the mean for 62 patients and longer than the mean for 30. The 23 input features were reduced by using stepwise linear discriminant analysis, and an ANN was developed with the six most statistically significant parameters (blood pressure, extent of inflammation, fluid aspiration, serum creatinine level, serum calcium level, and the presence of concurrent severe illness). With these features, the ANN successfully predicted whether the patient would exceed the mean length of stay (A z ϭ 0.83 Ϯ 0.05). Although the A z performance of the ANN was statistically significantly better than that of the Ranson (A z ϭ 0.68 Ϯ 0.06, P Ͻ .02) and Balthazar (A z ϭ 0.62 Ϯ 0.06, P Ͻ .003) grades, it was not significantly better than that of linear discriminant analysis (A z ϭ 0.82 Ϯ 0.05, P ϭ .53).Conclusion. An ANN may be useful for predicting outcome in patients with acute pancreatitis. Key Words. Computers, diagnostic aid; computers, ANN; pancreatitis. © AUR, 2002An episode of acute pancreatitis may run a variable and unpredictable course (1,2). Prediction of the likely severity of an episode in an individual patient is difficult but has implications for the institution of therapy and for patient information. For this reason, several predictive systems have been devised. Some of these systems are based on clinical criteria (eg, the Ranson and the acute physiology and chronic health evaluation [APACHE] scoring systems [2-4]), whereas others, such as the Balthazar system (5,6), are based on radiologic features at computed tomography (CT) (Fig 1). To our knowledge, no system has been devised in which both clinical and radiologic indicators are combined to predict severity or outcome. In this study, this task was investigated by using two multivariate decision model approaches: an artificial neural network (ANN) and linear discriminant analysis.ANNs are computer models composed of parallel, nonlinear computational elements arranged in layers with a

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Section: Discussionmentioning

confidence: 99%

Outcome Analysis of Patients with Acute Pancreatitis by Using an Artificial Neural Network

Keogan

Freed

et al. 2002

Academic Radiology

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“…Enhanced CT demonstrated diffuse pancreatic enlargement and edema. BALTHAZAR grade C (Enlarged pancreas associated with haziness and increased density of peripancreatic fat) [7].…”

Section: Case Presentationmentioning

confidence: 99%

Parathyroid Carcinoma Presenting as an Acute Pancreatitis

Cadena¹,

Romero‐Rojas²

2017

IJRRT

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Parathyroid carcinoma is the cause of only 1% of hyperparathyroidism cases. The incidence of acute pancreatitis in patients with hyperparathyroidism was reported to be only 1.5%. The occurrence of pancreatitis in patients with parathyroid carcinoma is unusual, ranging from 0% to 15%. Here, we report a very rare case of parathyroid carcinoma presenting as an acute pancreatitis in a 45 years old woman, who was suspected for hypercalcemia and higher levels of intact parathyroid hormone. The parathyroid carcinoma was verified with ultrasound, CT Scan, and single-photon emission computed tomography. The pathological anatomy report showed a minimally invasive parathyroid carcinoma. Following surgery, the patient was free after almost a 4 years follow up.

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“…Two authors extracted data independently from each article including the following: author, year of publication, sample size, study design, etiology, predictive severity scores before [20]; Acute Physiology And Chronic Health Evaluation-II (APACHE-II) score [21], organ failure before percutaneous catheter drainage, computed tomography severity index (CTSI) scores [22][23][24], catheter size, time between hospital admission and PCD, definitive successful treatment with PCD alone (defined as no need for additional surgical intervention), number of patients requiring an additional surgical intervention, complications, and mortality.…”

Section: Data Extractionmentioning

confidence: 99%

Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

et al. 2016

Indian J Surg

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The primary aim of this study was to present the outcomes of percutaneous catheter drainage (PCD) in patients with infected pancreatitis necrosis. A second aim was to focus on disease severity, catheter size, and additional surgical intervention. A literature search of the PubMed/MEDLINE/Cochrane Library (January 1998 to February 2015) databases was conducted. All randomized, non-randomized, and retrospective studies with data on PCD techniques and outcomes in patients with infected pancreatitis necrosis were included. Studies that reported data on PCD along with other interventions without the possibility to discriminate results specific to PCD were excluded. The main outcomes were mortality, major complications, and definitive successful treatment with percutaneous catheter drainage alone. Fifteen studies of 577 patients were included. There was only one randomized, controlled trial, and most others were retrospective case series. Organ failure before PCD occurred in 55.3 % of patients. With PCD alone, definitive successful treatment was 56.2 % of patients. Additional surgical intervention was required after PCD in 38.5 % of patients. The overall mortality rate was 18 % (104 of 577 patients). Complications occurred in 25

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Acute pancreatitis: prognostic value of CT.

Cited by 548 publications

References 0 publications

Outcome Analysis of Patients with Acute Pancreatitis by Using an Artificial Neural Network

Outcome Analysis of Patients with Acute Pancreatitis by Using an Artificial Neural Network

Parathyroid Carcinoma Presenting as an Acute Pancreatitis

Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

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