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Pancreatology. 2010;10(5):613-9. doi: 10.1159/000308795. Epub 2010 Oct 30.

Update of the Atlanta Classification of severity of acute pancreatitis: should a moderate category be included?

Author information

1
Unidad de Gastroenterología, Hospital General Universitario de Alicante, Alicante, España. madaria@hotmail.com

Abstract

BACKGROUND:

Persistent and multiple organ failure (POF and MOF) are predictive of death in acute pancreatitis (AP). Local complications without organ failure are associated with morbidity but a low risk of mortality.

AIM:

To design a three-category classification of AP severity and to compare it with the Atlanta Classification (AC) in terms of morbidity and mortality.

METHOD:

Severe AP was defined as death, POF (>48 h) or MOF. Moderate AP was defined as the presence of acute collections and/or pancreatic necrosis. Mild AP was defined by exclusion. We compared this classification with AC in 144 episodes of AP.

RESULTS:

In the three-category classification, severe AP was associated with significantly more frequent intensive care unit admission, invasive treatment and mortality than moderate and mild AP (p < 0.01). Severe AP patients required longer hospital stay and more nutritional support than mild AP patients (p < 0.01). Patients with moderate AP had significantly longer hospital stay and more need for nutritional support than patients with mild AP (p < 0.01). Five patients died, all of them with MOF and/or POF.

CONCLUSIONS:

A three-category classification distinguishes three homogeneous groups of severity.

PMID:
21042037
DOI:
10.1159/000308795
[Indexed for MEDLINE]
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