Acute pancreatitis: an update on the revised Atlanta classification

Colvin, Stephanie D.; Smith, Elainea N.; Morgan, Desiree E.; Porter, Kristin K.

doi:10.1007/s00261-019-02214-w

Cited by 57 publications

(56 citation statements)

References 47 publications

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“…Organ failure and local or systemic complications are used for this type of classification. [7][8][9] In our study, all patients with mortality were in the severe RAC group. As mentioned earlier, one of the severity scoring systems is the BISAP score, which can detect patients at risk of death or severe illness early in the AP course.…”

Section: Discussionmentioning

confidence: 64%

“…[3][4][5][6] Revised Atlanta classification (RAC) is another clinical and radiological classification to estimate the severity of AP that organ failure and local or systemic complications are used for this type of classification. [7][8][9] Metabolic syndrome (MetS) as a common problem is the combination of metabolic abnormalities including central obesity, hyperglycemia, hypertriglyceridemia, highdensity lipoprotein cholesterol (HDL-C), and hypertension. MetS is associated with increased mortality and morbidity but lifestyle modifications and some medication can reverse metabolic risk factors.…”

Section: Introductionmentioning

confidence: 99%

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<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

Niknam¹,

Moradi²,

Jahanshahi³

et al. 2020

DMSO

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Background: Acute pancreatitis (AP) and metabolic syndrome (MetS) are common clinical problems with serious complications and high cost of treatment. The relationship between MetS and severity of AP is unknown, and because there are very few published articles, further studies had been recommended. Therefore, we designed this study to estimate the association between MetS and its components with AP severity. Patients and Methods: In this prospective analytical cross-sectional study, all AP patients who referred to two referral hospitals affiliated with Shiraz University of Medical Sciences between 2016 and 2019 were evaluated. The diagnosis of MetS syndrome as well as follow-up of patients for evaluation of severity and outcome of AP was performed in all enrolled patients. National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) was used for diagnosis of MetS. Bedside Index for Severity in Acute Pancreatitis (BISAP) and revised Atlanta classification (RAC) were used to estimate the severity of AP. Finally, the association between MetS syndrome and its components at different AP severities was compared. Results: Of the 214 patients referred to our center, a total of 76 patients with AP were included in this study. Of the included patients, 40 (52.6%) were male and 36 (47.4%) were female. Frequency of patients in Mets and non-MetS groups was 34 (44.74%) and 42 (55.26%), respectively. The gender and mean age difference between Mets and non-MetS groups were not statistically significant. According to Mets groups, 25 (73.5%) and 9 (26.5%) AP patients with MetS had BISAP score of 0-2 and 3-5, respectively. BISAP score in MetS group was significantly higher than non-MetS group (P = 0.022). Overall, 20 (58.8%), 11 (32.4%), and 3 (8.8%) of AP patients with MetS had mild, moderately severe, and severe AP based on RAC, respectively. Severe RAC was significantly higher in the MetS group than in the non-MetS group (P = 0.029). The frequency of complications in MetS group was significantly higher than in non-MetS group (P= 0.008). The length of hospital stay was also significantly higher in the MetS group than in the non-MetS group (P = 0.001). Overall, three patients died, two of whom had MetS and all had severe RAC and BISAP 3-5. Waist circumference, fasting blood sugar, and triglyceride were significantly higher in the severe and moderately severe types of AP group than in the mild AP group, according to RAC. Although, mean of all components of MetS except HDL-cholesterol were higher in BISAP of 3-5 group than BISAP of 0-2 group, the difference was only significant in waist circumference. Conclusion: The present study showed that there was a significant association between the rate of MetS and its components including waist circumference, hyperglycemia and hypertriglyceridemia with increasing AP severity. This study showed that the incidence of more severe AP in patients with MetS is much higher than in patients without MetS. We recommend that the new studies with larger sample sizes are conducted wit...

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

Niknam¹,

Moradi²,

Jahanshahi³

et al. 2020

DMSO

View full text Add to dashboard Cite

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“…The hospital automation system was used to screen patient records according to the ICD-10 (K85) diagnosis code. Patients over 18 years of age, who did not have any trauma, who were not pregnant, who had no hematological malignancy, who were diagnosed with Acute Pancreatitis according to the Revised Atlanta Criteria, and who had sufficient data in their records were included in the study [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluating the effect of SARS-Cov-2 infection on prognosis and mortality in patients with acute pancreatitis

Karaali

Topal

2021

The American Journal of Emergency Medicine

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Introduction Acute pancreatitis (AP) is the leading cause of hospitalization among gastrointestinal disorders. The aim of our study is to compare the results between AP patients with and without COVID−19, and to reveal the effects of COVID−19 on the course, intensive care needs and mortality of AP patients. Material methods This was a single-center, retrospective and observational study. Patients over 18 years of age, who were diagnosed with AP during the current pandemic. According to the RT-PCR test result, patients were divided into two groups: COVID-19 positive and COVID-19 negative. Gender, age, laboratory parameters, intensive care unit admission, length of hospital stay, severity and mortality of AP were compared between these two groups. Results We reviewed 562 patients presenting to the emergency department who were diagnosed with acute pancreatitis between 10.03.2020 and 31.12.2020 and included 189 patients in our study. Positive patients need for intensive care (7.23%) were higher compared to negative patients (0.94%). 32.53% of positive patients and 14.15% of negative patients had severe AP ( p < 0.03). We established that being COVID-19 positive, CCI scores of ≥5, presence of COVID-19 compatible pneumonia on CT and BISAP scores had an effect on mortality ( p < 0,05). Conclusion The severity and mortality of AP increase in patients with both AP and COVID-19. This rate increases even more in the presence of COVID-19-associated pneumonia. We believe that new strategies should be developed for the follow-up and treatment of patients with both these conditions.

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“…En el presente estudio definimos pertinencia de la indicación de la TAC abdominal si el paciente contaba con ultrasonografía abdominal positiva y cumplía con los criterios de diagnóstico de Atlanta (15) , los cuales son historia clínica del paciente bien documentado sobre dolor abdominal o de espalda, un nivel de amilasa o lipasa superior a 3 veces el límite superior de lo normal, indicación de la TAC luego de las 48 horas y que aclaró y/o confirmó el diagnóstico y tuvo impacto en su tratamiento.…”

Section: Definiciones Y Medicionesunclassified

Associated factors for the indication of computed tomography in patients with suspected acute pancreatitis

Lau-Torres¹,

Caballero-Alvarado²,

Concepción-Urteaga³

2021

rmt

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aMagister en Medicina bDoctor en Investigación Clínica y Traslacional c Doctor en Medicina RESUMEN Objetivos: Determinar si la edad, el sexo, el tiempo de enfermedad, la leucocitosis, el hematocrito, la glicemia, la creatitina, la bilirrubina total y la amilasa sérica son factores asociados a la pertinencia de la indicación tomográfica axial computarizada en pacientes con sospecha de pancreatitis aguda. Materiales y Métodos: Se realizó un estudio de corte transversal en el Hospital Regional Docente de Trujillo, en el que se evaluó 623 pacientes con sospecha de pancreatitis aguda, luego que se excluyeran a aquellos que no cumplieron los criterios de inclusión, la muestra final fue 573 pacientes. Resultados: La prevalencia de pertinencia de la indicación tomográfica fue 7,68%. El análisis bivariado identificó al hematocrito, la glicemia sérica, la creatinina sérica y la amilasa sérica como factores asociados a la pertinencia tomográfica. El análisis multivariado identificó a las variables independientemente asociadas a la pertinencia tomográfica en pacientes con sospecha de pancreatitis aguda al tiempo de enfermedad (ORa = 1,167 IC 95% [

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Acute pancreatitis: an update on the revised Atlanta classification

Cited by 57 publications

References 47 publications

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

Evaluating the effect of SARS-Cov-2 infection on prognosis and mortality in patients with acute pancreatitis

Associated factors for the indication of computed tomography in patients with suspected acute pancreatitis

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