Predicting Acute Pancreatitis Severity: A Comparative Analysis of Computed Tomography Severity Index, Including Fat and Muscle Parameters

Abstract

Aim: The aim of this study was to investigate whether computed tomography-measured intra-abdominal fat and muscle parameters could improve the accuracy of acute pancreatitis severity assessment using the computed tomography severity index. Methods: This retrospective study included clinical and imaging parameters of 87 patients with acute pancreatitis. Patients were assessed by the computed tomography severity index. Asan J-Morphometry (Seoul, Korea), an ImageJ-based software (NIH, USA), was used to quantify abdominal muscle and fat areas. Total fat area, superficial fat area, visceral fat area, total muscle area and total muscle-fat area were calculated. The severity of acute pancreatitis was determined according to the revised Atlanta classification. Interreader agreement assessments, univariate and multivariate analyses were performed. Results: No significant differences were found in intra-abdominal fat and muscle parameters between groups with or without systemic or local complications (p > 0.05). When the patients were categorized as mild and severe disease based on computed tomography severity index score, no significant differences were found in fat and muscle parameters (p > 0.05). Surgery, systemic complications, and a high total computed tomography severity index score significantly increased the risk of local complications, with odds ratios of 0.001, 141.9, and 2.42, respectively. The intraclass correlation coefficients (ICC) were ≥ 0.90 between the readers. Conclusions: In this study, our study suggested that computed tomography -measured fat and muscle parameters did not significantly improve the accuracy of computed tomography severity index in predicting severity of acute pancreatitis.

Keywords

• acute pancreatitis
• atlanta classification
• computed tomography
• computed tomography severity index
• disease severity
• fat
• muscle

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