Criteria for the diagnosis and severity stratification of acute pancreatitis

Makoto Otsuki, Kazunori Takeda, Seiki Matsuno, Yasuyuki Kihara, Masaru Koizumi, Masahiko Hirota, Tetsuhide Ito, Kesho Kataoka, Motoji Kitagawa, Kazuo Inui, Yoshifumi Takeyama

Research output: Contribution to journalReview articlepeer-review

34 Citations (Scopus)

Abstract

Recent diagnostic and therapeutic progress for severe acute pancreatitis (SAP) remarkably decreased the case-mortality rate. To further decrease the mortality rate of SAP, it is important to precisely evaluate the severity at an early stage, and initiate appropriate treatment as early as possible. Research Committee of Intractable Diseases of the Pancreas in Japan developed simpler criteria combining routinely available data with clinical signs. Severity can be evaluated by laboratory examinations or by clinical signs, reducing the defect values of the severity factors. Moreover, the severity criteria considered laboratory/clinical severity scores and contrast-enhanced computed tomography (CE-CT) findings as independent risk factors. Thus, CE-CT scans are not necessarily required to evaluate the severity of acute pancreatitis. There was no fatal case in mild AP diagnosed by the CE-CT severity score, whereas casemortality rate in those with SAP was 14.8%. Case-mortality of SAP that fulfilled the laboratory/clinical and the CE-CT severity criteria was 30.8%. It is recommended, therefore, to perform CE-CT examination to clarify the prognosis in those patients who were diagnosed as SAP by laboratory/clinical severity criteria. Because the mortality rate of these patients with SAP is high, such patients should be transferred to advanced medical units.

Original languageEnglish
Pages (from-to)5798-5805
Number of pages8
JournalWorld Journal of Gastroenterology
Volume19
Issue number35
DOIs
Publication statusPublished - Sep 21 2013

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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