Objective: To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).
Methods: Clinical data of 337 traditional SAP patients, who were admitted to Peking Union Medical College Hospital (PUMCH) from January 2001 to December 2012, were retrospectively studied. These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP. Disease severity, therapy and prognosis among three groups were compared.
Results: Among the total 337 traditional SAP patients, 253 were classified as MSAP and 84 as SAP. In the group of SAP, 40 patients were categorized as CAP and 44 as non-CAP. Compared with non-CAP patients, CAP patients had significantly higher mortality rate which was 70% (28/40). Other results were all significantly higher in CAP group rather than non-CAP group, including ICU admission rate 77.5% (31/40), length of ICU stay (15.5 ± 20.6) days, Ranson, APACHE II, BISAP, MCTSI, modified Marshall scores 4.6 ± 1.4, 16.8 ± 5.8, 3.0 ± 1.0, 8.6 ± 1.7, and 7.4 ± 2.9, respectively (P < 0.01 in each endpoint). These parameters of SAP group were also significantly higher than those of MSAP group (P < 0.01).
Conclusions: Using the new three-category classification to distinguish traditional severe acute pancreatitis, namely MSAP, SAP, and CAP, can better reflect the severity of disease, predict outcome and guide clinical management.