title: JPN Guidelines for the management of acute pancreatitis: severity assessment of acute pancreatitis.
abstract: This article addresses the criteria for severity assessment and the severity scoring system of the Ministry of Health and Welfare of Japan; now the Japanese Ministry of Health, Labour, and Welfare (the JPN score). It also presents data comparing the JPN score with the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Ranson score, which are the major measuring scales used in the United States and Europe. The goal of investigating these scoring systems is the achievement of earlier diagnosis and more appropriate and successful treatment of severe or moderate acute pancreatitis, which has a high mortality rate. This article makes the following recommendations in terms of assessing the severity of acute pancreatitis: (1) Severity assessment is indispensable to the selection of proper initial treatment in the management of acute pancreatitis (Recommendation A). (2) Assessment by a severity scoring system (JPN score, APACHE II score) is important for determining treatment policy and identifying the need for transfer to a specialist unit (Recommendation A). (3) C-reactive protein (CRP) is a useful indicator for assessing severity (Recommendation A). (4) Contrast-enhanced computed tomography (CT) scanning and contrast-enhanced magnetic resonance imaging (MRI) play an important role in severity assessment (Recommendation A). (5) A JPN score of 2 or more (severe acute pancreatitis) has been established as the criterion for hospital transfer (Recommendation A). (6) It is preferable to transfer patients with severe acute pancreatitis to a specialist medical institution where they can receive continuous monitoring and systemic management.
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Kumamoto 860-0811, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawarada
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Miho
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Kazunori
authors.initials: K
authors.lastname: Takeda
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
authors.forename: Masaru
authors.initials: M
authors.lastname: Koizumi
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
authors.forename: Seiki
authors.initials: S
authors.lastname: Matsuno
mesh_terms: D018806:APACHE; D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003952:Diagnostic Imaging; D006801:Humans; D007564:Japan; D010195:Pancreatitis / Q000503:physiopathology*; D012017:Referral and Consultation; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein