Clinical evaluations of the revised staging system for acute pancreatitis in Japan

Abstract

In 2008, the Japanese clinical staging system for acute pancreatitis has been revised. This new staging system employs only 9 prognostic factors and an enhanced CT grading system. It is easy to make an assessment of the severity for a wide variety of clinicians. Using this new staging system, we will divide all pancreatitis patients into 2 categories, severe and mild. The aim of this study was to clarify the difference of the severity between the new staging system and the existing staging system for acute pancreatitis. We evaluated this new staging system using our past 217 pancreatitis cases. On this new system, 37 (17.1%) were severe cases, 180 (82.9%) were mild cases. The rate of severe pancreatitis changed from 26.7% to 17.1%, and the rate of mild changed from 52.1% to 82.9%. We tried to make a conversion formula from the existing system's severity score to the new system's severity score. The formula is. In light of this formula, the new system's 3 points is equal to 7.8 points in the existing system. The rate of mortality at 3 points in the new system's score is 14.3%. From this study, we can show that the new staging system's severity is higher than the existing system's severity. We have to enhance recognition about the new staging system's severity. When we judge 'severe pancreatitis' on this new system, we should transfer to an intensive care unit where systemic management of severe acute pancreatitis is available.