Predicting the Prognosis of Acute Pancreatitis
Authors: Chris E. Forsmark, Dhiraj Yadav
Journal: Annals of Internal Medicine (2016)

Editorials4 October 2016Predicting the Prognosis of Acute PancreatitisChris E. Forsmark, MD and Dhiraj Yadav, MD, MPHChris E. Forsmark, MDFrom University of Florida, Gainesville, Florida, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.Search for more papers by this author and Dhiraj Yadav, MD, MPHFrom University of Florida, Gainesville, Florida, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1581 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinicians find value in predicting the prognosis and course of disease in individual patients. All diseases have intrinsic variability in risk, severity, and outcome, which is driven by differences in individual susceptibility, general health, and physiologic reserve, as well as in the processes and pathogenicity of the disease. For example, patients with gastrointestinal bleeding due to peptic ulcer may be stratified into high- and low-risk groups through the use of scoring systems to assess patient characteristics and bleeding volume, and by the ulcer's appearance during initial endoscopy. This stratification allows clinicians to triage patients, identify the appropriate therapy, and determine ...References1. Rockall TA, Logan RF, Devlin HB, Northfield TC. Selection of patients for early discharge or outpatient care after acute upper gastrointestinal haemorrhage. National Audit of Acute Upper Gastrointestinal Haemorrhage. Lancet. 1996;347:1138-40. [PMID: 8609747] CrossrefMedlineGoogle Scholar2. Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas. 2006;33:323-30. [PMID: 17079934] CrossrefMedlineGoogle Scholar3. Peery AF, Crockett SD, Barritt AS, Dellon ES, Eluri S, Gangarosa LM, et al. Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology. 2015;149:1731-1741. [PMID: 26327134] doi:10.1053/j.gastro.2015.08.045 CrossrefMedlineGoogle Scholar4. Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400. [PMID: 17032204] CrossrefMedlineGoogle Scholar5. Di MY, Liu H, Yang ZY, Bonis PAL, Tang JL, Lau J. Prediction models of mortality in acute pancreatitis in adults. A systematic review. Ann Intern Med. 2016;165:482-90. doi:10.7326/M16-0650 LinkGoogle Scholar6. Mounzer R, Langmead CJ, Wu BU, Evans AC, Bishehsari F, Muddana V, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology. 2012;142:1476-82; quiz e15-6. [PMID: 22425589] doi:10.1053/j.gastro.2012.03.005 CrossrefMedlineGoogle Scholar7. Koutroumpakis E, Wu BU, Bakker OJ, Dudekula A, Singh VK, Besselink MG, et al. Admission hematocrit and rise in blood urea nitrogen at 24 h outperform other laboratory markers in predicting persistent organ failure and pancreatic necrosis in acute pancreatitis: a post hoc analysis of three large prospective databases. Am J Gastroenterol. 2015;110:1707-16. [PMID: 26553208] doi:10.1038/ajg.2015.370 CrossrefMedlineGoogle Scholar8. Renner IG, Savage WT, Pantoja JL, Renner VJ. Death due to acute pancreatitis. A retrospective analysis of 405 autopsy cases. Dig Dis Sci. 1985;30:1005-18. [PMID: 3896700] CrossrefMedlineGoogle Scholar9. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102-11. [PMID: 23100216] doi:10.1136/gutjnl-2012-302779 CrossrefMedlineGoogle Scholar10. Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS, et al; Pancreatitis Across Nations Clinical Research and Education Alliance (PANCREA). Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Ann Surg. 2012;256:875-80. [PMID: 22735715] doi:10.1097/SLA.0b013e318256f778 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Florida, Gainesville, Florida, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.Disclosures: Dr. Yadav has served as a consultant for AbbVie and has received royalties from Up-To-Date, outside the submitted work. Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1581.Corresponding Author: Chris E. Forsmark, MD, Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Box 100214, 1329 Southwest 16th Street, Suite 5251, Gainesville, FL 32610; e-mail, chris.[email protected]ufl.edu.Current Author Addresses: Dr. Forsmark: Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Box 100214, 1329 Southwest 16th Street, Suite 5251, Gainesville, FL 32610.Dr. Yadav: Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, 200 Lothrop Street, M-2, C-Wing, Pittsburgh, PA 15213.This article was published at www.annals.org on 26 July 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrediction Models of Mortality in Acute Pancreatitis in Adults Meng-Yang Di , Hao Liu , Zu-Yao Yang , Peter A.L. 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