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Einteilung des Schweregrads der akuten Pankreatitis: Internationale, multidisziplinäre klinische Klassifikation auf Basis pathogenetischer Determinanten: Deutsche Version 2013

2013; Thieme Medical Publishers (Germany); Volume: 51; Issue: 6 Linguagem: Inglês

1439-7803

E. Patchen Dellinger, Christopher E. Forsmark, Peter Layer, Philippe Lévy, E. Maraví-Poma, Maxim S. Petrov, Tooru Shimosegawa, Ajith K. Siriwardena, Generoso Uomo, David C. Whitcomb, John A. Windsor, Mohammad Abu Hilal, Fikri M. Abu‐Zidan, J. M. Acosta, Alan Patrick Ainsworth, M. Aizcorbe Garralda, Hakan Alagözlü, Subhi J. Al’Aref, Eduardo Albéniz, A Alhajeri, Iara Carnevale de Almeida, Jomar Luiz Santos Almeida, Hiroki Amano, Basil J. Ammori, Roger Andersson, Åke Andrén‐Sandberg, José Celso Ardengh, Abel Salvador Arroyo-Sánchez, Marianna Arvanitakis, S. W. Ashley, Gülbin Aygencel, W. A. Ayoub, Jessica Baillie, M Bala, Carol Ball, T. Baron, Savio George Barreto, Metin Başaranoğlu, H. G. Beger, Vanesa Bernal Monterde, Nishat Bharwani, Deepak K. Bhasin, Jan Jin Bong, G Botoi, T. Bruennler, Ernesto Cairoli, C. R. Carter, Daniela Cernea, Suresh T. Chari, RM Charnley, S. Chooklin, D Cochior, Cavit Çöl, Darwin L. Conwell, María Isabel Toulson Davisson Correia, Z. Dambrauskas, Katalin Darvas, Tércio De Campos, Gonzalo García de Casasola Sánchez, Jan J. De Waele, Marco Del Chiaro, G. Delle Fave, E. Patchen Dellinger, Enrique de‐Madaria, Pierluigi Di Sebastiano, Т. Г. Дюжева, Andrés Duarte‐Rojo, Peter J. Fagenholz, Gyula Farkas, Antonio Farré Viladrich, Carlos Fernández‐del Castillo, Christopher E. Forsmark, H Friess, J. L. Frossard, V.C. Gandhi, Timothy B. Gardner, B. Gloor, M. Gluk, V. R. Goltsov, José Guevara-Campos, A. A. Gumbs, T. Hackert, Goran Hauser, Karen D. Horvath, Howard Thomas, Hisaki Igarashi, O. Ioannidis, S Jaber, F. E. James, Rajiv Jha, Deven Juneja, Terumi Kamisawa, P. Kandasami, Murat Kantarcıoğlu, Vishal Kapoor, Tarkan Karakan, Ergün Barış Kaya, Amir A. Khaliq, Seiki Kiriyama, Rakesh Kochhar, George Ν. Konstantinou, Marja‐Leena Kylänpää, P. G. Lankisch, C. Laplaza Santos, Jan Lata, Peter Layer, Ari Leppäniemi, Patrick Lévy, AB Moráis López, V. López Camps, L. A. Lujano-Nicolás, Hans Lund, Dimitrios Lytras, L. Macaya Redin, Miriam Machado, M. Azcona Rodríguez, O. Mann, E. Maraví-Poma, M Marincaş, Sanjay Marwah, E. Mas, A. S. Matheus, R. Meier, D Mennecier, Panu Mentula, A Mifkovič, Reza Mofidi, Damian J. Mole, G. Morris-Stiff, J Mössner, Münife Müftüoğlu, Michael Munsell, Avery B. Nathens, Vincenzo Neri, Camilla Nøjgaard, Isto Nordback, Carlos Ocampo, Attila Oláh, J Olejník, Derek O’Reilly, Alejandro Oría, Józefa Panek, Georgios I. Papachristou, Dhruv Parekh, Rowan W. Parks, Carolyn Passaglia, Callum B. Pearce, Débora Pellegrini, Miguel Pérez‐Mateo, Maxim S. Petrov, Ville Pettilä, Raffaele Pezzilli, C. S. Pitchumoni, Supot Pongprasobchai, I. Poves Prim, Pauli Puolakkainen, G. Pupelis, Dejan Radenković, Shahnaz Rahman, E. Regidor Sanz, Alejandro Repiso, Luı́s Rodrigo, Arne R. Rosseland, Grażyna Rydzewska, J.Á. Sánchez-Izquierdo Riera, Thomas J. Savides, Mariano Scaglione, Alejandro Serrablo, Erick Servín-Torres, I. Sethu, Özde Sezgin, Manu Shankar‐Hari, Tooru Shimosegawa, M. V. Singer, Saroj K. Sinha, Ajith K. Siriwardena, Tomas Sjöberg Bexelius, James Skipworth, Francisco García Soriano, R. Sotoudehmanesh, B.W.M. Spanier, Borut Štabuc, Cezar Stroescu, Zsolt Szentkereszty, Tamás Takács, Tadahiro Takada, K Takeda, Yoshifumi Takeyama, Winson W. Tang, Katsuhisa Tanjoh, P Tarnasky, Niels Teich, José M. Tellado, Scott Tenner, Angus J.M. Thomson, Mustafa Tireli, Tong Zhang, Charikleia Triantopoulou, Generoso Uomo, M. C. Uy, Erwin JM van Geenen, Antonio José Velasco, Nereo Vettoretto, Christian Vollmer, Keita Wada, A. L. Warshaw, Avi A. Weinbroum, David C. Whitcomb, J. Wilson, Mathias Wittau, Bizhao Wu, Arkadiusz Peter Wysocki, Esther Quirós, Takeshi Yasuda, Yu Chen, Enver Zerem, Xiaoshuang Zhou, F. Zubia Olazcoaga, N.J. Zyromski,

Healthcare cost, quality, practices

Objective: The aim of this study was to develop a new international classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of published evidence, and worldwide consultation. Background: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric descriptions 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, intensive medicine specialists, and radiologists who are currently active in clinical research on acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global Web-based survey was conducted and a dedicated international symposium was organised to bring contributors from different disciplines together and discuss the concept and definitions. Result: The new international classification is based on the actual local and systemic determinants of severity, rather than descriptions 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. Conclusions: This classification is the result of a consultative process amongst pancreatologists from 49 countries spanning North America, South America, Europe, Asia, Oceania, and Africa. It 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. This ensures that the determinant-based classification can be used in a uniform manner throughout the world.