title: A descriptive study evaluating the circumstances of medical treatment for acute pancreatitis before publication of the new JPN guidelines based on the Japanese administrative database associated with the Diagnosis Procedure Combination system.
abstract: OBJECTIVE
  To examine the circumstances of medical treatment for acute pancreatitis before publication of the new Japanese (JPN) guidelines using the Japanese administrative database associated with the Diagnosis Procedure Combination system.
  
  
  METHODS
  We collected data from 7,193 patients with acute pancreatitis in 2008 and examined the recommended medical treatment in the new JPN guidelines [from recommendations B (considered to be recommended treatments) to D (considered to be unacceptable treatments)] according to severity of acute pancreatitis. Patients were divided into two groups: mild cases (n = 6,520) and severe cases (n = 673).
  
  
  RESULTS
  Enteral nutrition for severe cases without ileus (recommendation B) was uncommon (13.5%). In contrast, prophylactic antibiotics were administered in a large number (80.4%) of mild cases without acute cholangitis (recommendation D). Furthermore, administration of H(2) receptor antagonists, except for cases of upper gastrointestinal bleeding (recommendation D), were performed in many patients with both mild and severe cases (66.8 vs. 78.6%).
  
  
  CONCLUSIONS
  This study demonstrated a discrepancy between actual medical treatment performed and the new JPN guidelines with regard to some of the medical treatments. Future studies are required after publication of the new JPN guidelines to determine how they affect medical treatments.
authors: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan. amurata@med.uoeh-u.ac.jp
authors: Atsuhiko
authors: A
authors: Murata
authors: Shinya
authors: S
authors: Matsuda
authors: Toshihiko
authors: T
authors: Mayumi
authors: Masamichi
authors: M
authors: Yokoe
authors: Kazuaki
authors: K
authors: Kuwabara
authors: Yukako
authors: Y
authors: Ichimiya
authors: Yoshihisa
authors: Y
authors: Fujino
authors: Tatsuhiko
authors: T
authors: Kubo
authors: Kenji
authors: K
authors: Fujimori
authors: Hiromasa
authors: H
authors: Horiguchi
mesh_terms: D019072:Antibiotic Prophylaxis / Q000592:standards*; D003938:Diagnostic Techniques, Digestive System / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000628:therapy*; D010506:Periodicals as Topic; D017410:Practice Guidelines as Topic