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亚特兰大急性胰腺炎严重程度分类的更新:是否应包括中度类别?

Update of the Atlanta Classification of severity of acute pancreatitis: should a moderate category be included?

机构信息

Unidad de Gastroenterología, Hospital General Universitario de Alicante, Alicante, España.

出版信息

Pancreatology. 2010;10(5):613-9. doi: 10.1159/000308795. Epub 2010 Oct 30.

Abstract

BACKGROUND

Persistent and multiple organ failure (POF and MOF) are predictive of death in acute pancreatitis (AP). Local complications without organ failure are associated with morbidity but a low risk of mortality.

AIM

To design a three-category classification of AP severity and to compare it with the Atlanta Classification (AC) in terms of morbidity and mortality.

METHOD

Severe AP was defined as death, POF (>48 h) or MOF. Moderate AP was defined as the presence of acute collections and/or pancreatic necrosis. Mild AP was defined by exclusion. We compared this classification with AC in 144 episodes of AP.

RESULTS

In the three-category classification, severe AP was associated with significantly more frequent intensive care unit admission, invasive treatment and mortality than moderate and mild AP (p < 0.01). Severe AP patients required longer hospital stay and more nutritional support than mild AP patients (p < 0.01). Patients with moderate AP had significantly longer hospital stay and more need for nutritional support than patients with mild AP (p < 0.01). Five patients died, all of them with MOF and/or POF.

CONCLUSIONS

A three-category classification distinguishes three homogeneous groups of severity.

摘要

背景

持续性和多器官衰竭(POF 和 MOF)是急性胰腺炎(AP)死亡的预测因素。无器官衰竭的局部并发症与发病率相关,但死亡率低。

目的

设计一种急性胰腺炎严重程度的三分类,并与亚特兰大分类(AC)在发病率和死亡率方面进行比较。

方法

严重 AP 定义为死亡、POF(>48 小时)或 MOF。中度 AP 定义为存在急性积聚和/或胰腺坏死。轻度 AP 通过排除来定义。我们将这种分类与 144 例 AP 进行了比较。

结果

在三分类中,严重 AP 与 ICU 入院、侵袭性治疗和死亡率明显高于中度和轻度 AP 相关(p < 0.01)。严重 AP 患者的住院时间和营养支持需求明显高于轻度 AP 患者(p < 0.01)。中度 AP 患者的住院时间和营养支持需求明显长于轻度 AP 患者(p < 0.01)。5 例患者死亡,均伴有 MOF 和/或 POF。

结论

三分类可区分三种严重程度均一的组别。

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