OBJECTIVES: To determine which classification is more accurate in stratifying severity. METHODS: The study used a retrospective analysis of a prospective acute @entity788 database (June 2005-December 2007). Acute @entity788 severity was stratified according to the Atlanta classification (AC) 1992, the revised Atlanta classification (RAC) 2012, and the determinant-based classification (DBC) 2012. Receiver operating characteristic analysis (area under the curve) compared the accuracy of each classification. Logistic regression identified predictors of mortality. RESULTS: 338 @entity1 were analyzed: 13% had @entity881 ( @entity881 ) (>48 hours), of whom 37% had multisystem @entity881 , and 11% had @entity39 , of whom 19% had infected @entity39 . Mortality was 4.1%. For predicting mortality (area under the curve), the RAC (0.91) and DBC (0.92) were comparable (P = 0.404); both outperformed the AC (0.81) (P < 0.001). For intensive care unit admission, the RAC (0.85) and DBC (0.85) were comparable (P = 0.949); both outperformed the AC (0.79) (P < 0.05). There were 2 @entity1 in the critical category of the DBC. Multisystem @entity881 was an independent predictor of mortality (odds ratio, 75.0; 95% confidence interval, 13.7-410.6; P < 0.001), whereas single-system @entity881 , sterile @entity39 , and infected @entity39 were not. CONCLUSION: The RAC and DBC were generally comparable in stratifying severity. The paucity of @entity1 in the critical category in the DBC limits its utility. Neither classification accounts for the impact of multisystem @entity881 , which was the strongest predictor of mortality.

The Atlanta Classification, Revised Atlanta Classification, and Determinant-Based Classification of Acute XXXX : Which Is Best at Stratifying Outcomes?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatitis'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis', 'pancreatic necrosis'] @entity881 :: ('MESH:D009102', 'Disease') :: ['POF', 'persistent organ failure']
@entity788 :: (MESH:D010190,Disease) :: ['Pancreatitis']
