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

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
• persistent SIRS
• acute fluid collection

Disclosure statement

Mouen Khashab: Consultant for Boston Scientific, Xlumena and Olympus.

Anthony Kalloo: Equity holder for Apollo Endosurgery.

Vikesh Singh: Consultant for Abbvie, Ariel, Akcea, and Novo Nordisk, Advisory board participant for Nordmark.

All the other authors have no disclosures.