Clinical Importance of the Determinant-Based Classification of Acute Pancreatitis Severity
D. Cochior, S. Constantinoiu, C. Copăescu, D. Șerbănoiu, R. Birlă, M. BoeriuOriginal article, no. 5, 2013
Purpose: This classification should eliminate the confusion interminology occurring over the last 20 years with direct implicationsin clinical practice.Method: The study was based on the web-based consultation ofexperts worldwide. 528 invitations were sent and 240 responsesreceived from 49 countries from all continents.Results: In an attempt to eliminate many confusions of the oldclassification, definitions that have built-in modern conceptsof the disease have been issued, clinical evaluation of theseverity has been improved and a standardized reporting datato objectively evaluate new treatments and to facilitate thecommunication of data between centers has been created.Discussions: An ideal classification should reflect the wholearea of clinical and paraclinical changes for one patient, at agiven time. In the chosen classification, the main variable thatcharacterizes the degree of severity is only the transitory orpersistent organ dysfunction(s) failure(s). Conclusions: The most significant contribution to this updateis redefining local complications based on their content,existence or non-existence of the wall, the place of theirappearance and their evolution over time (local determinants).Systemic determinants take into account the presence of organfailures (transient or persistent). The presence of determinantfactors has a cumulative effect.
