Pancreatic necrosis volume for predicting readmission and reintervention in acute necrotizing pancreatitis. Issue 154 (September 2022)

• Record Type: Journal Article
• Authors: Liao, Qian; Ding, Ling; Xu, Xin; Yu, Chen; Deng, Feng; Xiong, Huifang; He, Wenhua; Xia, Liang; Zeng, Xianjun; Lu, Nonghua; Zhu, Yin
• Is Part Of: European journal of radiology. Issue 154(2022)
• Publication Date: 2022-09
• Subjects: Acute pancreatitis -- Necrotizing pancreatitis -- Pancreatic necrosis volume -- Readmission -- Intervention; PNV pancreatic necrosis volume -- NP necrotizing pancreatitis -- CT computed tomography -- IQR interquartile range -- OR odds ratio -- CI confidence interval -- CTSI computed tomography severity index -- AP acute pancreatitis -- EXPN extrapancreatic necrosis -- PPN pancreatic parenchymal necrosis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110419
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Readmission and reintervention are important issues in necrotizing pancreatitis. Pancreatic necrosis volume is strongly associated with these prognosis. The imaging technique of quantification necrosis is worthy of clinical application. Management of patients with necrotizing pancreatitis becomes more appropriate. Abstract: Purpose: To determine the correlation between the pancreatic necrosis volume (PNV) and readmission as well as reintervention. Method: This was a retrospective cohort study that included necrotizing pancreatitis (NP) patients who were examined with contrast-enhanced computed tomography (CT) one week before discharge. The PNV was calculated manually based on the postprocessing workstation software. Multivariate logistic regression analysis was employed to determine the independent risk factors for readmission and reintervention. Results: A total of 167 NP patients were included. Among them, 94 (56.3%) patients were readmitted after discharge, and 55 (32.9%) patients needed further invasive intervention. The median PNV of all patients was 376.6 (interquartile range (IQR), 129.3–820.5) cm 3, and the PNV was significantly higher in patients needing readmission or reintervention. Multivariate analysis showed that PNV ≥ 620 cm 3 (adjusted odds ratio (adjOR), 3.08; 95% confidence interval (CI), 1.47–6.43; P = 0.003) and modified computed tomography severity index (CTSI) score ≥ 7 points (adjOR, 6.36; 95% CI, 2.05–10.70; P = 0.001) were independently associated with readmission. Stent or drainage tube placement at discharge (adjOR, 2.94; 95% CI, 1.27–6.77; P = 0.011), PNV ≥ 620 cm 3 (adjOR, 5.11; 95% CI, 2.19–11.95; P < 0.001), pancreatic parenchymal necrosis (adjOR, 3.37; 95% CI, 1.42–7.96; P = 0.006), and modified CTSI score ≥ 7 points (adjOR, 4.23; 95% CI, 1.46–12.27; P = 0.008) were independent risk factors for reintervention. Conclusions: The PNV is a useful tool for quantifying pancreatic necrosis and is strongly associated with readmission and reintervention. Additional prospective studies with larger sample sizes are needed to confirm these findings.