Association Between Severity and the Determinant-Based Classification, Atlanta 2012 and Atlanta 1992, in Acute Pancreatitis A Clinical Retrospective Study
Association Between Severity and the Determinant-Based Classification, Atlanta 2012 and Atlanta 1992, in Acute Pancreatitis A Clinical Retrospective Study
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DOI：
10.1097/md.0000000000000638
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发表时间：
2015-04-01
期刊：
影响因子：
1.6
通讯作者：
Li, Jieshou
中科院分区：
文献类型：
--
作者：
Chen, Yuhui;Tong, Zhihui;Li, Jieshou
最近，人们提出了基于判定项的分类(DBC)和Atlanta 2012，为急性胰腺炎(AP)的研究和治疗提供了依据。本研究旨在评估严重程度与AP的DBC、2012年亚特兰大和1992年亚特兰大之间的关系。对2007年1月至2013年7月收治的急性胰腺炎患者进行回顾性分析，将患者分为3个分类系统的严重程度类别。主要结果包括长期临床预后(死亡率和住院时间)、主要并发症(腹内出血、多器官功能障碍、单器官衰竭和脓毒症)和临床干预(手术引流、持续肾脏替代治疗[CRRT]持续时间和机械通气[MV]持续时间)。根据上述主要结果，对分类系统进行了验证和比较。共有395名患者参加了这项回顾性研究，总体住院死亡率为8.86%。腹内出血27例(6.84%)，多器官功能障碍73例(18.48%)，单一器官功能障碍67例(16.96%)，脓毒症73例(18.48%)。对于每个分类系统，不同的严重程度类别与统计学上不同的临床死亡率、主要并发症和临床干预措施相关(P
Recently, the determinant-based classification (DBC) and the Atlanta 2012 have been proposed to provide a basis for study and treatment of acute pancreatitis (AP). The present study aimed to evaluate the association between severity and the DBC, the Atlanta 2012 and the Atlanta 1992, in AP. Patients admitted to our center with AP from January 2007 to July 2013 were reviewed retrospectively.Patients were assigned to severity categories for all the 3 classification systems. The primary outcomes include long-term clinical prognosis (mortality and length-of-hospital stay), major complications (intraabdominal hemorrhage, multiple-organ dysfunction, single organ failure [OF], and sepsis) and clinical interventions (surgical drainage, continuous renal replace therapy [CRRT] lasting time, and mechanical ventilation [MV] lasting time). The classification systems were validated and compared in terms of these abovementioned primary outcomes.A total of 395 patients were enrolled in this retrospective study with an overall 8.86% in-hospital mortality. Intraabdominal hemorrhage was present in 27 (6.84%) of the patients, multiple-organ dysfunction in 73(18.48%), single OF in 67 (16.96%), and sepsis in 73(18.48%). For each classification system, different categories regarding severity were associated with statistically different clinical mortality, major complications, and clinical interventions (P