Comparison Of Three Classification Criteria For Acute Pancreatitis

Objective:To validate and compare the determinant-based classification (DBC) and a revision of the Atlanta classification (RAC), and their standard features and applicability.Methods:A retrospective analysis from January2013to December2013in Xiangya Hospital9ward admitted205cases of acute pancreatitis(AP) cases meet the Atlanta classification AC), in accordance with the determinant-based classification and the revised classification in Atlanta, its classification and reanalyze their overall in-hospital mortality, need for admission to the intensive care unit(ICU), length of hospital stay, nutritional support, invasive treatment, local complications, organ failure.Results:1. In205cases of patients with the clinical diagnosis of AP, according to AC,108cases (51.2%) and100cases (48.8%) were classified as mild and severe AP. According to DBC,108cases (54.2%),76cases (37.1%),15cases (7.3%) and6cases (2.9%) were classified as mild, moderate, severe and critical of the AP. According to RAC,79cases (38.5%),109cases (53.2%),17cases (8.3%) were classified as mild, moderately severe and severe AP;2. The different categories of severity for each classification system were associated with statistically significant differences (p<0.05) in length of hospital stay, need for admission to the intensive care unit, and in-hospital mortality. The different categories of AC in invasive treatment was not statistically significant; The different categories of severity for each classification system in nutritional support was not statistically significant;3. The similar categories of severity for RAC and ABC system in length of hospital stay, need for admission to the intensive care unit, and in-hospital mortality was not statistically significant.Conclusion:1. The DBC and the RAC accurately classify the severity of AP in subgroups nof patients.2. The unique category of severe acute pancreatitis according to the AC may include different (and substantial) degrees of severity, which is necessary to identify a patient group defined as "moderately severe acute pancreatitis or moderately acute pancreatitis".3. No significant difference was found between the SAP and the CSAP categories within DBC group.4.No significant difference was found between the DBC and the RAC of similar categories.