How severe is moderately severe acute pancreatitis? Clinical validation of revised 2012 Atlanta Classification

Table 1 Patients’ characteristics n (%)

Variable	All patients (n = 103)
Male	54 (52.4)
Necrotic	48 (46.6)
Edematous	55 (53.4)
Etiology
Alcohol	44 (42.7)
Alimentary	27 (26.2)
Biliary	27 (26.2)
Idiopathic	5 (4.9)
Atlanta 1992
Mild	56 (54.4)
Severe	47 (45.6)
Atlanta 2012
Mild	49 (47.6)
Moderately severe	27 (26.2)
Severe	27 (26.2)
Interventions
US guided drainage	6 (5.8)
Fasciotomy	1 (1)
Necrosectomy	5 (4.9)
APACHE II (mean ± SD)	7.1 ± 5.32
MODS (mean ± SD)	2.6 ± 2.91
Sepsis	6 (5.8)
Mortality	13 (12.6)

APACHE: Acute Physiology and Chronic Health Evaluation; US: Ultrasound; MODS: Multiple organ dysfunction syndrome.

Table 2 Comparison of severe acute pancreatitis group outcomes

	Atlanta 1992	Atlanta 2012	P value
ICU admission (n)	5	6	0.32
US drainage (n)	5	4	0.71
Infected necrosis (n)	12	11	0.19
Deaths (n)	13	13	0.75

US: Ultrasound; ICU: Intensive care unit.

Table 3 Comparison of mild and severe acute pancreatitis (Atlanta 1992) n (%)

	Mild	Severe	P value
Male	29 (51.8)	25 (53.2)	1.000
Necrosis
Sterile	55 (98.2)	41 (87.2)	0.343
Infected	1 (1.8)	6 (12.8)	0.054
Sepsis	0 (0)	6 (12.8)	0.011
Interventions
Fine needle aspiration	1 (1.8)	12 (25.5)	0.002
US guided drainage	1 (1.8)	5 (10.6)	0.101
Necrosectomy	0 (0)	6 (12.7)	0.011
APACHE II, mean ± SD	3.51 ± 1.94	11.48 ± 4.79	< 0.001
MODS, mean ± SD	1.17 ± 1.28	4.29 ± 3.38	< 0.001
Deaths	0 (0)	13 (27.7)	< 0.001

APACHE: Acute Physiology and Chronic Health Evaluation; US: Ultrasound; MODS: Multiple organ dysfunction syndrome.

Table 4 Comparison of moderately severe and severe acute pancreatitis (Atlanta 2012) n (%)

	Moderately severe	Severe	P value
Male	15 (55.6)	16 (59.3)	1.000
Necrosis
Sterile	26 (96.3)	22 (81.5)	0.696
Infected	1 (3.7)	5 (18.5)	0.201
Sepsis	0 (0)	6 (22.2)	0.028
Interventions
Fine needle aspiration	2 (7.4)	10 (37.0)	0.053
US guided drainage	1 (3.7)	4 (14.8)	0.356
Necrosectomy	0 (0)	6 (22.2)	0.028
APACHE II, mean ± SD	7.7 ± 3.07	13.2 ± 5.43	0.002
MODS, mean ± SD	2.9 ± 1.78	5.2 ± 3.90	< 0.001
ICU admission	5 (18.5)	24 (88.9)	0.004
Deaths	0 (0)	13 (27.7)	0.001

APACHE: Acute Physiology and Chronic Health Evaluation; US: Ultrasound; MODS: Multiple organ dysfunction syndrome; ICU: Intensive Care Unit.