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Validation of the moderate severity category of acute pancreatitis defined by determinant-based classification

查看全文 作　　者：Tao [1]Jin;Wei [1,2]Huang;Xiao-Nan [1]Yang;Ping [1]Xue;Muhammad A [2]Javed;Kiran [2]Altaf;Robert [2]Sutton;Qing [1]Xia 高影响力作者 机构地区：[1]Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center, West China Hospital, Sichuan University;[2]NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool and Broadgreen University Hospitals Trust and University of Liverpool高影响力机构 出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2014年第13卷第3期,共5页高影响力期刊 基　　金：supported by grants from Science and Technology Support Program of Sichuan(2009SZ0201,2010SZ0068 and 2011SZ0291);National Institute for Health Research,UK 摘　　要：BACKGROUND: Recent international multidisciplinary consultation proposed the use of local(sterile or infected pancreatic necrosis) and/or systemic determinants(organ failure) in the stratification of acute pancreatitis. The present study was to validate the moderate severity category by international multidisciplinary consultation definitions.METHODS: Ninety-two consecutive patients with severe acute pancreatitis(according to the 1992 Atlanta classification) were classified into(i) moderate acute pancreatitis group with the presence of sterile(peri-) pancreatic necrosis and/or transient organ failure; and(ii) severe/critical acute pancreatitis group with the presence of sterile or infected pancreatic necrosis and/or persistent organ failure. Demographic and clinical outcomes were compared between the two groups.RESULTS: Compared with the severe/critical group(n=59), the moderate group(n=33) had lower clinical and computerized tomographic scores(both P<0.05). They also had a lower incidence of pancreatic necrosis(45.5% vs 71.2%, P=0.015),infection(9.1% vs 37.3%, P=0.004), ICU admission(0% vs27.1%, P=0.001), and shorter hospital stay(15±5 vs 27±12days; P<0.001). A subgroup analysis showed that the moderate group also had significantly lower ICU admission rates, shorter hospital stay and lower rate of infection compared with the severe group(n=51). No patients died in the moderate group but7 patients died in the severe/critical group(4 for severe group).CONCLUSIONS: Our data suggest that the definition of moderate acute pancreatitis, as suggested by the international multidisciplinary consultation as sterile(peri-) pancreatic necrosis and/or transient organ failure, is an accurate category of acute pancreatitis. 关 键 词：acute PANCREATITIS pancreatic NECROSIS ORGAN failure determinant-based classification
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