Clinical Outcomes and Prognostic Significance of Early vs. Late Computed Tomography in Acute Pancreatitis

Background and Aim: The prevalence of acute pancreatitis is still high with a mortality rate of 10-20% for the past two decades. Acute pancreatitis can be prognosis with computed tomography (CT) which correlates clinical outcomes, complications, and associated mortality rate. The current study aims were to evaluate the clinical outcomes and prognostic significance of early vs. late computed tomography in acute pancreatitis. Methodology: A cross-sectional study was carried out on 136 consecutive acute pancreatitis patients in the department of Gastroenterology and Radiology, Bahawal Victoria Hospital, Bahawalpur for duration of one year from August 2020 to July 2021. Patients with no abdominal CT due to pregnancy and CT performed after 14 days of pain onset were excluded. All the patients were categorized into two groups; Group-I where CT was performed after 4-5 days of pain onset and Group-II CT performed after 6-14 days of pain onset. The CT findings such as prognostic information, CT severity index and local complications were compared in both group. For data collection and analysis, SPSS version 21 was used. Results: Of the total 136 acute appendicitis patients, 92 (67.6%) were male and 44 (32.4%) were females with an age range of 18 to 60 years. The overall mean age was 42.45± 11.62 years. Group-I had 72 patients (early CT performed) and Group-II had 64 (47.1%) patients of late CT performed. The mean severity index of CT performed in early and late was 5.43±2.31 and 6.59±2.6; p=0.005). The severity index of CT was higher in late-performed computed tomography compared to early perform CT. The persistent organ failure had an almost similar incidence in both early and late CT performed (37.4% versus 48.7%; p<0.125). Late CT performed group majority patients had local complications 82.6% compared to 67.4%; p<0.021. No significant variance was found in surgery, percutaneous drainage need, and mortality (p>0.05). Conclusion: Our study found that early CT does not have a negative impact on the outcome of acute pancreatitis. However, local complications were detected with the onset of symptoms in computed tomography after 5-days. Performing computed tomography before the hospitalization sixth day does not result in earlier intervention. Keywords: Computed tomography, Acute pancreatitis, Clinical outcomes