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Med Intensiva. 2014 May;38(4):211-7. doi: 10.1016/j.medin.2013.03.013. Epub 2013 Jun 7.

[International multidisciplinary classification of acute pancreatitis severity: the 2013 Spanish edition].

[Article in Spanish]

Collaborators (210)

Abu Hilal M, Abu-Zidan FM, Acosta JM, Ainsworth AP, Aizcorbe Garralda M, Alagozlu H, Al'aref SJ, Albeniz Arbizu E, Alhajeri A, Almeida JL, Ammori BJ, Andersson R, Ardengh JC, Arroyo-Sanchez AS, Arvanitakis M, Ashley SW, Aygencel G, Ayoub WA, Baillie J, Bala M, Ball CG, Banks PA, Baron TH, Barreto SG, Basaranoglu M, Beger HG, Bernal Monterde V, Besselink MG, Bharwani N, Bhasin DK, Bong JJ, Botoi G, Bruennler T, Bruno MJ, Cairoli E, Carter CR, Cernea D, Chari ST, Chooklin S, Cochior D, Col C, Conwell DL, Correia MI, Dambrauskas Z, Darvas K, De Campos T, De Casasola GG, De Waele JJ, del Chiaro M, Delle Fave G, Dellinger EP, de-Madaria E, Dervenis C, di Sebastiano P, Diuzheva TG, Duarte-Rojo A, Fagenholz PJ, Farkas G, Farre Viladrich A, Fernandez-del Castillo C, Forsmark CE, Friess H, Frossard JL, Gandhi V, Gardner TB, Garg PK, Gloor B, Gluk M, Goltsov VR, Guevara-Campos J, Gumbs AA, Hackert T, Hauser G, Horvath KD, Howard TJ, Igarashi H, Ioannidis O, Jaber S, James FE, Jha RK, Johnson CD, Juneja D, Kamisawa T, Kandasami P, Kantarcioglu M, Kapoor VK, Karakan T, Kaya E, Khaliq A, Kiriyama S, Kochhar R, Konstantinou GN, Kylanpaa ML, Lankisch PG, Laplaza Santos C, Lata J, Layer P, Lerch MM, Levy P, Lopez A, Lopez Camps V, Lujano-Nicolas LA, Lund H, Lytras D, Macaya Redin L, Machado MC, Macias Rodriguez MA, Mann O, Maravi-Poma E, Marincas M, Marwah S, Mas E, Matheus AS, Mayerle J, Meier R, Mennecier D, Mifkovic A, Mofidi R, Mole DJ, Morris-Stiff G, Mossner J, Muftuoglu MA, Munsell MA, Nathens AB, Neri V, Nojgaard C, Nordback I, Ocampo C, Olejnik J, O'Reilly DA, Oria A, Panek J, Papachristou GI, Parekh D, Parks RW, Passaglia C, Pearce CB, Pellegrini D, Perez-Mateo M, Petrov MS, Pettila V, Pezzilli R, Pitchumoni CS, Pongprasobchai S, Poves Prim I, Puolakkainen P, Pupelis G, Radenkovic DV, Rahman SH, Rau B, Regidor Sanz E, Repiso A, Rodrigo L, Rydzewska G, Sánchez-Izquierdo Riera JA, Savides TJ, Scaglione M, Serrablo A, Servin-Torres E, Sethu I, Sezgin O, Shankar-Hari M, Shimosegawa T, Singer MV, Sinha SK, Siriwardena AK, Sjoberg Bexelius T, Skipworth JR, Soriano FG, Sotoudehmanesh R, Spanier BW, Stabuc B, Stroescu C, Szentkereszty Z, Takacs T, Takada T, Takeda K, Takeyama Y, Talukdar R, Tang W, Tanjoh K, Tarnasky PR, Teich N, Tellado JM, Tenner S, Thomson A, Tireli M, Tong Z, Triantopoulou C, Uomo G, Uy MC, van Geenen EJ, Vege SS, Velasco Guardado A, Vettoretto N, Wada K, Warshaw AL, Whitcomb DC, Wilson JS, Windsor J, Wittau M, Wu BU, Wysocki AP, Yan Quiros E, Yasuda T, Yu C, Zerem E, Zhou X, Zubia Olazcoaga F, Zyromski NJ.

Author information

1
UCI-B, Complejo Hospitalario de Navarra (antiguo Hospital Virgen del Camino), Pamplona, España. Electronic address: enrique.maravi.poma@hotmail.com.
2
Department of Surgery, University of Washington School of Medicine, Seattle, Estados Unidos.
3
Division of Gastroenterology, Hepatology, and Nutrition, University of Florida College of Medicine, Gainesville, Estados Unidos.
4
Department of Internal Medicine, Israelitic Hospital, Hamburgo, Alemania.
5
Pôle des Maladies de l'Appareil Digestif, Service de Gastroenterologie-Pancreatologie, Hopital Beaujon, Clichy, Francia.
6
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japón.
7
Department of Surgery, Manchester Royal Infirmary, University of Manchester, Manchester, Reino Unido.
8
Department of Internal Medicine, Cardarelli Hospital, Nápoles, Italia.
9
Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Department of Cell Biology and Molecular Physiology, Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, Estados Unidos.
10
Department of Surgery, University of Auckland, Miembro International Association of Pancreatology, Auckland, Nueva Zelanda.

Abstract

OBJECTIVE:

To develop a new classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of the published evidence, and worldwide consultation.

BACKGROUNDS:

The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of specialist in pancreatic diseases, but are suboptimal because these definitions are based on the empiric description of events not associated with severity.

METHODS:

A personal invitation to contribute to the development of a new classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists and radiologists currently active in the field of clinical acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global web-based survey was conducted, and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions.

RESULTS:

The new classification of severity is based on the actual local and systemic determinants of severity, rather than on the description of events that are non-causally associated with severity. The local determinant relates to whether there is (peri) pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another, whereby the presence of both infected (peri) pancreatic necrosis and persistent organ failure has a greater impact upon severity than either determinant alone. The derivation of a classification based on the above principles results in four categories of severity: mild, moderate, severe, and critical.

CONCLUSIONS:

This classification is the result of a consultative process among specialists in pancreatic diseases from 49 countries spanning North America, South America, Europe, Asia, Oceania and Africa. It provides a set of concise up to date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research. This ensures that the determinant-based classification can be used in a uniform manner throughout the world.

KEYWORDS:

(peri) pancreatic necrosis; Acute pancreatitis; Clasificación; Classification; Complicaciones infecciosas pancreáticas; Fracaso orgánico; Gravedad; Necrosis (peri)pancreática; Organ failure; Pancreatic infectious complications; Pancreatitis aguda; Severity

PMID:
23747189
DOI:
10.1016/j.medin.2013.03.013
[Indexed for MEDLINE]
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