ADDED VALUE OF CT CRITERIA COMPARED TO THE CLINICAL SAP SCORE IN PATIENTS WITH ACUTE-PANCREATITIS

Background: To assess the added value of established computed tomograp hy (CT) scores versus the Simplified Acute Physiology (SAP) score in p redicting outcome in patients with acute pancreatitis. Methods: Contra st-enhanced CT was performed in 45 patients with acute pancreatitis. T he Balthazar score, CT severity index (CTSI), and Schroder score were assessed, and the SAP score was calculated. The predictive values of C T score and SAP score for mortality, need for one or more intervention s, and length of hospital stay were compared. The added value of the S AP score to the CT scores was assessed by using ROC (receiver operatin g curve) analysis. Results: The positive predictive values of the high er Balthazar, CTSI, Schroder, and SAP scores, reflecting severe diseas e, were 50%, 41%, 41%, and 48%, respectively, for mortality, 85%, 84%, 84%, and 83%, respectively, for need for one or more interventions, a nd 55%, 66%, 66%, and 65%, respectively, for longer hospital stay. The negative predictive values of the lower Balthazar, CTSI, Schroder and SAP scores were 84%, 92%, 92%, and 42%, respectively, for mortality, 44%, 69%, 69%, and 45%, respectively, for need for one or more interve ntions, and 44%, 69%, 69%, and 55%, respectively, for longer hospital stay. When CT scores were added to the SAP score, there was no improve ment in discriminating power for mortality. Conclusion: To identify pa tients with severe outcome, there is no clear benefit using establishe d CT scores as opposed to the SAP score. However, the Balthazar score and CTSI are better than the SAP score in predicting a favorable outco me.