title: Prognostic markers in acute pancreatitis.
abstract: Acute pancreatitis has a mortality rate of 5-10%. Early deaths are mainly due to multiorgan failure and late deaths are due to septic complications from pancreatic necrosis. The recently described 2012 Revised Atlanta Classification and the Determinant Classification both provide a more accurate description of edematous and necrotizing pancreatitis and local complications. The 2012 Revised Atlanta Classification uses the modified Marshall scoring system for assessing organ dysfunction. The Determinant Classification uses the sepsis-related organ failure assessment scoring system for organ dysfunction and, unlike the 2012 Revised Atlanta Classification, includes infected necrosis as a criterion of severity. These scoring systems are used to assess systemic complications requiring intensive therapy unit support and intra-abdominal complications requiring minimally invasive interventions. Numerous prognostic systems and markers have been evaluated but only the Glasgow system and serum CRP levels provide pragmatic prognostic accuracy early on. Novel concepts using genetic, transcriptomic and proteomic profiling and also functional imaging for the identification of specific disease patterns are now required.
authors.affiliation: NIHR Pancreas Biomedical Research Unit, the Royal Liverpool University and Broadgreen Hospitals NHS Trust and the University of Liverpool, Liverpool L69 3GA, UK.
authors.forename: Ilias P
authors.initials: IP
authors.lastname: Gomatos
authors.forename: Xu
authors.initials: X
authors.lastname: Xiaodong
authors.forename: Paula
authors.initials: P
authors.lastname: Ghaneh
authors.forename: Christopher
authors.initials: C
authors.lastname: Halloran
authors.forename: Michael
authors.initials: M
authors.lastname: Raraty
authors.forename: Brian
authors.initials: B
authors.lastname: Lane
authors.forename: Robert
authors.initials: R
authors.lastname: Sutton
authors.forename: John P
authors.initials: JP
authors.lastname: Neoptolemos
mesh_terms: D015415:Biomarkers / Q000097:blood; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis* / Q000378:metabolism; D011379:Prognosis; D020543:Proteome / Q000378:metabolism; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D020543:Proteome