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Revision of the atlanta classification systems for acute pancreatitis 

The latest issue of the Clinical Gastroenterology & Hepatology validates and revises the determinant-based Atlanta Classification Systems for Acute Pancreatitis.

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Two new classification systems for the severity of acute pancreatitis (AP) have been proposed, the determinant-based classification (DBC) and a revision of the Atlanta classification (RAC).

Dr Enrique de–Madaria and colleagues from Spain validated and compared these classification systems.

The researchers analyzed data from adult patients with AP who were admitted to Hospital General Universitario de Alicante from 2007 to 2013.

Imaging results were reviewed, and the classification systems were validated and compared in terms of outcomes.

The research team found that pancreatic necrosis was present in 12% of patients, peripancreatic necrosis in 20%, walled-off necrosis in 11%, acute peripancreatic fluid collections in 18%, and pseudocysts in 4%.

Transient and persistent organ failures were present in 6% and 4%, respectively.

Transient organ failures were present in 6%
Clinical Gastroenterology & Hepatology

The team observed that 3% of patients died.

On the basis of the DBC, 71%, 24%, 4%, and less than 1% of patients were determined to have mild, moderate, severe, or critical AP, respectively.

On the basis of the RAC, 67%, 30%, and 4% of patients were determined to have mild, moderately severe, or severe AP, respectively.

The different categories of severity for each classification system were associated with statistically significant and clinically relevant differences in length of hospital stay, need for admission to the intensive care unit, nutritional support, invasive treatment, and in-hospital mortality.

In comparing similar categories between the classification systems, the researchers found no significant differences.

Dr de–Madaria's team concludes, "The DBC and the RAC accurately classify the severity of AP in subgroups of patients."

Clin Gastroenterol Hepatol 2014: 12(2): 311-316
10 February 2014

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