Moderately severe acute pancreatitis: prospective validation of this new subgroup of acute pancreatitis.
OBJECTIVE
We described the entity moderately severe acute pancreatitis (MSAP), characterized by local complications (LCs) without organ failure (OF). The aim of this study was to validate MSAP.


METHODS
We classified a prospectively collected cohort of 137 acute pancreatitis patients admitted to Mayo Clinic Hospitals into (a) severe acute pancreatitis (SAP; n = 15), presence of OF with/without LCs; (b) MSAP (n = 27), presence of LCs without OF; and (c) mild acute pancreatitis (MAP; n = 95), no OF and LCs. Primary outcomes were need for intensive care unit (ICU) care, total ICU days, total hospital stay, need for interventions, and death.


RESULTS
Scores in the Acute Physiology and Chronic Health Evaluation II during admission were significantly different among the 3 groups (MAP vs MSAP, P = 0.02; MSAP vs SAP, P = 0.001); scores in the systemic inflammatory response syndrome during admission were similar between MAP and MSAP. Compared with patients with MAP, patients with MSAP had a significantly longer hospital stay (4 [3.0-7.0] vs 6 [4.0-18.0] days). Compared with those with SAP, a significantly smaller proportion of patients with MSAP required ICU care (12% vs 80%); total hospital stay and need for interventions were similar (6 [4.0-18.0] vs 21 [11.8-27] days and 44% vs 33%, respectively). None of the MSAP patients died compared with 40% from the SAP group.


CONCLUSIONS
We have validated MSAP as an exclusive entity.
Mayo Clinic College of Medicine, Rochester, MN, USA.
Rupjyoti
R
Talukdar
Magdalen
M
Clemens
Santhi Swaroop
SS
Vege
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009102:Multiple Organ Failure / Q000209:etiology; D010195:Pancreatitis / Q000145:classification* / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology; D009626:Terminology as Topic; D013997:Time Factors