Development and use of a new staging system for severe acute pancreatitis based on a nationwide survey in Japan.
METHODS
In 1997, a cooperative nationwide survey of 192 patients diagnosed with severe acute pancreatitis in 1996 was carried out.


RESULTS
Alcoholic pancreatitis was the major etiology (46%), and the male-to-female ratio was 2.6:1. Overall, the mortality rate was 27%, which was similar to the rate (30%) in the first nationwide survey of 1,219 patients diagnosed between 1982 and 1986 that was performed in 1987. A marked difference between the surveys was the early mortality rate within 2 weeks: 52% in the 1987 survey and 29% in the current survey. We devised a new stage classification system for acute pancreatitis. Stages 0 and 1 are equivalent to mild and moderate conditions, respectively, in the conventional classification, and stages 2 and higher correspond to severe acute pancreatitis. Severity scores of 2-8 are regarded as stage 2, scores of 9-14, as stage 3, and scores of > or =15, as stage 4. The mortality rates were as follows: 0, stages 0 and 1 at hospitalization; approximately 10%, stage 2; approximately 30-40%, stage 3; and approximately 70-100%, stage 4.


CONCLUSIONS
We found that stage at hospitalization reflected the prognosis of acute pancreatitis.
Ogawa
Michio
M
Department of Surgery II, Kumamoto University Medical School, Kumamoto, Japan. mogawa@kaiju.medic.kumamoto-u.ac.jp
Hirota
Masahiko
M
Hayakawa
Tetsuo
T
Matsuno
Seiki
S
Watanabe
Shinichiro
S
Atomi
Yutaka
Y
Otsuki
Makoto
M
Kashima
Kei
K
Koizumi
Masaru
M
Harada
Hideo
H
Yamamoto
Masahiro
M
Nishimori
Isao
I
D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006306:Health Surveys; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000150:complications; D007564:Japan; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D012720:Severity of Illness Index; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome