November 12, 2014
Pancreatology. 2014 Jan-Feb;14(1):17-20. doi: 10.1016/j.pan.2013.11.006. Epub 2013 Nov 23.
Author Address: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: email@example.com.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan.
Reference Type: Journal Article
Record Number: 4805Author: Uomo, G., Patchen Dellinger, E., Forsmark, C. E., Layer, P., Levy, P., Maravi-Poma, E., Shimosegawa, T., Siriwardena, A. K., Whitcomb, D. C., Windsor, J. A. and Petrov, M. S.
Title: [Multidisciplinar international classification of the severity of acute pancreatitis: Italian version 2013]
Journal: Minerva Med
Short Title: [Multidisciplinar international classification of the severity of acute pancreatitis: Italian version 2013]
Alternate Journal: Minerva medica
ISSN: 0026-4806 (Print)
Original Publication: Classificazione Internazionale Multidisciplinare della Gravita della Pancreatite Acuta Versione Italiana 2013.
Accession Number: 24316918
Keywords: Acute Disease
Pancreatitis, Acute Necrotizing/classification/diagnosis
*Severity of Illness Index
Abstract: AIM: The aim of this paper was to present the 2013 Italian edition of a new international classification of acute pancreatitis severity. The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric description of occurrences that are merely associated with severity. METHODS: A personal invitation to contribute to the development of a new international classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists, and radiologists who are currently active in clinical research on acute pancreatitis. A global web-based survey was conducted and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions. RESULTS: The new international classification is based on the actual local and systemic determinants of severity, rather than description of events that are correlated with severity. The local determinant relates to whether there is (peri)pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another such that the presence of both infected (peri)pancreatic necrosis and persistent organ failure have a greater effect on severity than either determinant alone. The derivation of a classification based on the above principles results in 4 categories of severity-mild, moderate, severe, and critical. CONCLUSION: This classification provides a set of concise up-to-date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research.