Unidad de Gastroenterología, Hospital General Universitario de Alicante, Alicante, España.
Pancreatology. 2010;10(5):613-9. doi: 10.1159/000308795. Epub 2010 Oct 30.
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.
To design a three-category classification of AP severity and to compare it with the Atlanta Classification (AC) in terms of morbidity and mortality.
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.
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.
A three-category classification distinguishes three homogeneous groups of severity.
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。
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。
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。
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。
三分类可区分三种严重程度均一的组别。