Jun-Ho Choi1, Myung-Hwan Kim2, Dongwook Oh3, Woo Hyun Paik3, Do Hyun Park3, Sang Soo Lee3, Dong-Wan Seo3, Sung Koo Lee3. 1. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea. 2. Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. Electronic address: mhkim@amc.seoul.kr. 3. Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Abstract
BACKGROUND/ OBJECTIVE: Recognizing the limitation of the Atlanta classification for acute pancreatitis (AP), two international classifications have been recently proposed; the revised Atlanta classification and the determinant-based classification. There is an inconsistency between the two international classifications on whether infected necrosis (IN) is the major determinant of severity in AP. The aim of the current study was to validate the revised Atlanta classification and to determine the association of this new classification system with relevant clinical outcome in patients with AP. METHODS: Data have been collected on 553 patients with AP admitted to a single center during the 7-year period commencing January 2006. Primary outcomes included the need for interventions, the need for intensive care unit (ICU) care, length of ICU stay, total hospital stay, and mortality. RESULTS: The different grades of severity for revised Atlanta classification system were associated with statistically significant differences in terms of clinical outcomes. Patients with severe AP that had IN, compared to those without IN, were associated with worse clinical outcomes. Having stratified patients with severe AP category according to the presence or absence of IN, the mortality rate increased fourfold to 32.3% for the presence of infected necrosis. CONCLUSIONS: Overall, the revised Atlanta classification seems to be valid, since it correlates well with clinical outcome. To more accurately assess clinical outcome of patients with severe AP defined by the revised Atlanta classification, however, severe AP patients with IN should be considered separately from those without IN in classification system.
BACKGROUND/ OBJECTIVE: Recognizing the limitation of the Atlanta classification for acute pancreatitis (AP), two international classifications have been recently proposed; the revised Atlanta classification and the determinant-based classification. There is an inconsistency between the two international classifications on whether infected necrosis (IN) is the major determinant of severity in AP. The aim of the current study was to validate the revised Atlanta classification and to determine the association of this new classification system with relevant clinical outcome in patients with AP. METHODS: Data have been collected on 553 patients with AP admitted to a single center during the 7-year period commencing January 2006. Primary outcomes included the need for interventions, the need for intensive care unit (ICU) care, length of ICU stay, total hospital stay, and mortality. RESULTS: The different grades of severity for revised Atlanta classification system were associated with statistically significant differences in terms of clinical outcomes. Patients with severe AP that had IN, compared to those without IN, were associated with worse clinical outcomes. Having stratified patients with severe AP category according to the presence or absence of IN, the mortality rate increased fourfold to 32.3% for the presence of infected necrosis. CONCLUSIONS: Overall, the revised Atlanta classification seems to be valid, since it correlates well with clinical outcome. To more accurately assess clinical outcome of patients with severe AP defined by the revised Atlanta classification, however, severe AP patients with IN should be considered separately from those without IN in classification system.
Authors: Ari Leppäniemi; Matti Tolonen; Antonio Tarasconi; Helmut Segovia-Lohse; Emiliano Gamberini; Andrew W Kirkpatrick; Chad G Ball; Neil Parry; Massimo Sartelli; Daan Wolbrink; Harry van Goor; Gianluca Baiocchi; Luca Ansaloni; Walter Biffl; Federico Coccolini; Salomone Di Saverio; Yoram Kluger; Ernest Moore; Fausto Catena Journal: World J Emerg Surg Date: 2019-06-13 Impact factor: 5.469
Authors: Emese Réka Bálint; Gabriella Fűr; Lóránd Kiss; Dávid István Németh; Alexandra Soós; Péter Hegyi; Zsolt Szakács; Benedek Tinusz; Péter Varjú; Áron Vincze; Bálint Erőss; József Czimmer; Zoltán Szepes; Gábor Varga; Zoltán Rakonczay Journal: Sci Rep Date: 2020-10-21 Impact factor: 4.379