title: Atlanta, revised Atlanta, and Determinant-based classification--application in a cohort of Portuguese patients with acute pancreatitis.
abstract: BACKGROUND
  Acute pancreatitis (AP) represents a complex and potentially fatal disease with a highly variable clinical course. Three classification systems for assessing the severity in AP have been validated for clinical use.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the performance of the Atlanta and Determinant-based classifications in predicting severe clinical outcomes in patients with AP.
  
  
  METHODS
  In this retrospective study we reviewed the treatment and follow-up records of 525 patients with AP admitted to our unit between the years of 2003 and 2014. Outcomes included mortality, admission to the ICU, need for interventional procedures or nutritional support, and duration of hospital and ICU stay.
  
  
  RESULTS
  The prevalence of organ failure and persistent organ failure in our cohort was 23.0 and 10.7%, respectively, and the mortality rate was 5.9%. Higher grades of severity were associated with worse outcomes in all classification systems. The revised Atlanta and Determinant-based classifications performed similarly in predicting outcomes, and both proved to be superior to the former classic Atlanta classification.
  
  
  CONCLUSIONS
  Recent classifications proved to be more accurate in predicting important clinical outcomes in patients with AP.
authors.affiliation: Department of Gastroenterology and Hepatology, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Fernandes
authors.forename: Joana
authors.initials: J
authors.lastname: Carvalho
authors.forename: Patrícia
authors.initials: P
authors.lastname: Santos
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Moura
authors.forename: Teresa
authors.initials: T
authors.lastname: Antunes
authors.forename: José
authors.initials: J
authors.lastname: Velosa
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology* / Q000628:therapy; D018529:Nutritional Support / Q000706:statistics & numerical data; D010195:Pancreatitis / Q000145:classification* / Q000150:complications / Q000401:mortality / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data; D011174:Portugal; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index