CAJ | 학술논문

BACKGROUND:?Recent?international?multidisciplinary?consulta- tion?proposed?the?use?of?local?(sterile?or?infected?pancreatic?necrosis)? and/or? systemic? determinants? (organ? failure)? in?the?stratiifcation?of?acute?pancreatitis.?The?present?study?was?to?validate?the?moderate?severity?category?by?international?multidisciplinary?consultation?deifnitions. <br> METHODS:?Ninety-two?consecutive?patients?with?severe?acute?pancreatitis?(according?to?the?1992?Atlanta?classiifcation)?were?classiifed?into?(i)?moderate?acute?pancreatitis?group?with?the?presence?of?sterile?(peri-)?pancreatic?necrosis?and/or?transient?organ?failure;?and?(ii)?severe/critical?acute?pancreatitis?group?with?the?presence?of?sterile?or?infected?pancreatic?necrosis?and/or?persistent?organ?failure.?Demographic?and?clinical?outcomes?were?compared?between?the?two?groups. <br> RESULTS:?Compared?with?the?severe/critical?group?(n=59),?the?moderate?group?(n=33)?had?lower?clinical?and?computerized?tomographic?scores?(both?P<0.05).?They?also?had?a?lower?incidence?of?pancreatic?necrosis?(45.5%?vs?71.2%,?P=0.015),?infection?(9.1%?vs?37.3%,?P=0.004),?ICU?admission?(0%?vs?27.1%,?P=0.001),?and?shorter?hospital?stay?(15±5?vs?27±12?days;?P<0.001).?A?subgroup?analysis?showed?that?the?moderate?group?also?had?signiifcantly?lower?ICU?admission?rates,?shorter?hospital?stay?and?lower?rate?of?infection?compared?with?the?severe?group?(n=51).?No?patients?died?in?the?moderate?group?but?7?patients?died?in?the?severe/critical?group?(4?for?severe?group). <br> CONCLUSIONS:?Our? data? suggest? that? the? deifnition? of?moderate?acute?pancreatitis,?as?suggested?by?the?international?multidisciplinary? consultation? as? sterile? (peri-)? pancreatic?necrosis?and/or?transient?organ?failure,?is?an?accurate?category?of?acute?pancreatitis.