Development and Use of a New Staging System for Severe Acute Pancreatitis Based on a Nationwide Survey in Japan
2002; Lippincott Williams & Wilkins; Volume: 25; Issue: 4 Linguagem: Inglês
10.1097/00006676-200211000-00001
ISSN1536-4828
AutoresMichio Ogawa, Masahiko Hirota, Tetsuo Hayakawa, Seiki Matsuno, Shinichiro Watanabe, Yutaka Atomi, Makoto Otsuki, Kei Kashima, Masaru Koizumi, Hideo Harada, Masahiro Yamamoto, Isao Nishimori,
Tópico(s)Appendicitis Diagnosis and Management
ResumoMethodology In 1997, a cooperative nationwide survey of 192 patients diagnosed with severe acute pancreatitis in 1996 was carried out. Results Alcoholic pancreatitis was the major etiology (46%), and the male-to-female ratio was 2.6:1. Overall, the mortality rate was 27%, which was similar to the rate (30%) in the first nationwide survey of 1,219 patients diagnosed between 1982 and 1986 that was performed in 1987. A marked difference between the surveys was the early mortality rate within 2 weeks: 52% in the 1987 survey and 29% in the current survey. We devised a new stage classification system for acute pancreatitis. Stages 0 and 1 are equivalent to mild and moderate conditions, respectively, in the conventional classification, and stages 2 and higher correspond to severe acute pancreatitis. Severity scores of 2–8 are regarded as stage 2, scores of 9–14, as stage 3, and scores of ≥15, as stage 4. The mortality rates were as follows: 0, stages 0 and 1 at hospitalization; ≈10%, stage 2; ≈30–40%, stage 3; and ≈70–100%, stage 4. Conclusion We found that stage at hospitalization reflected the prognosis of acute pancreatitis.
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