title: Validation of 'moderately severe acute pancreatitis' in patients with acute pancreatitis.
abstract: BACKGROUND
  Severe acute pancreatitis, according to Atlanta classification, is a heterogeneous group of patients with different outcomes. The patients with local complications and without organ failure have better outcome. This study has been conducted to determine the proportion of moderately severe acute pancreatitis and validate this subgroup in our population of patients.
  
  
  METHODS
  A total of 172 patients with the diagnosis of acute pancreatitis were categorized into three groups according to presence or absence of local complications and organ failure as mild acute pancreatitis, moderately severe acute pancreatitis and severe acute pancreatitis and were compared in terms of need for intensive care unit care, length of ICU stay, need for intervention, length of hospital stay and mortality.
  
  
  RESULTS
  Fifty seven (33%) were categorized as moderately severe acute pancreatitis. Need for ICU care (19.3% vs 100%, p<0.001), length of ICU stay (1 vs 9.8 days, p<0.001), length of hospital stay (8.3±3.7 vs 16.6±8.1 days, p<0.001) and mortality (0% vs 33.3%, p<0.001) between moderately severe acute pancreatitis and severe acute pancreatitis was significantly different. Moreover, mild acute pancreatitis and moderately severe acute pancreatitis had no mortality.
  
  
  CONCLUSIONS
  This study showed that moderately severe acute pancreatitis exists as a separate group different from mild acute pancreatitis and severe acute pancreatitis with no mortality as in mild acute pancreatitis.
authors.affiliation: Department of Surgery, TUTH, Kathmandu, Nepal.
authors.forename: Paleswan Joshi
authors.initials: PJ
authors.lastname: Lakhey
authors.affiliation: Department of Surgery, TUTH, Kathmandu, Nepal.
authors.forename: Ramesh Singh
authors.initials: RS
authors.lastname: Bhandari
authors.affiliation: Department of Surgery, TUTH, Kathmandu, Nepal.
authors.forename: Brindeshwori
authors.initials: B
authors.lastname: Kafle
authors.affiliation: Department of Surgery, TUTH, Kathmandu, Nepal.
authors.forename: Keshaw Prasad
authors.initials: KP
authors.lastname: Singh
authors.affiliation: Department of Surgery, TUTH, Kathmandu, Nepal.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Khakurel
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000145:classification* / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index