Moderately Severe Acute Pancreatitis: Prospective Validation of This New Subgroup of Acute Pancreatitis

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Abstract

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.

Abbreviations

AP - acute pancreatitis, SAP - severe acute pancreatitis, MSAP - moderately severe acute pancreatitis, MAP - mild acute pancreatitis, OF - organ failure, CT - computerized tomography, ICU - intensive care unit, BMI - body mass index, SIRS - systemic inflammatory response syndrome, APACHE - Acute Physiology and Chronic Health Evaluation, IQR - interquartile range

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