TY - JOUR
T1 - Criteria for the diagnosis and severity stratification of acute pancreatitis
AU - Otsuki, Makoto
AU - Takeda, Kazunori
AU - Matsuno, Seiki
AU - Kihara, Yasuyuki
AU - Koizumi, Masaru
AU - Hirota, Masahiko
AU - Ito, Tetsuhide
AU - Kataoka, Kesho
AU - Kitagawa, Motoji
AU - Inui, Kazuo
AU - Takeyama, Yoshifumi
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/9/21
Y1 - 2013/9/21
N2 - 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.
AB - 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.
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U2 - 10.3748/wjg.v19.i35.5798
DO - 10.3748/wjg.v19.i35.5798
M3 - Review article
C2 - 24124324
AN - SCOPUS:84885618167
VL - 19
SP - 5798
EP - 5805
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 35
ER -