@article{114bcc4bac714fc1818857cb0b802205,
title = "Determinant-based classification of acute pancreatitis severity: An international multidisciplinary consultation",
abstract = "OBJECTIVE: To develop a new international classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of published evidence, and worldwide consultation. BACKGROUND: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric description of occurrences that are merely associated with severity. METHODS: A personal invitation to contribute to the development of a new international classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists, and radiologists who are currently active in clinical research on acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global Web-based survey was conducted and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions. RESULT: The new international classification is based on the actual local and systemic determinants of severity, rather than description of events that are correlated with severity. The local determinant relates to whether there is (peri)pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another such that the presence of both infected (peri)pancreatic necrosis and persistent organ failure have a greater effect on severity than either determinant alone. The derivation of a classification based on the above principles results in 4 categories of severity-mild, moderate, severe, and critical. CONCLUSIONS: This classification is the result of a consultative process amongst pancreatologists from 49 countries spanning North America, South America, Europe, Asia, Oceania, and Africa. It provides a set of concise up-to-date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research. This ensures that the determinant-based classification can be used in a uniform manner throughout the world.",
keywords = "acute pancreatitis, classification, organ failure, pancreatic infectious complications, pancreatic necrosis, peripancreatic necrosis, severity",
author = "Dellinger, {E. Patchen} and Forsmark, {Christopher E.} and Peter Layer and Philippe L{\'e}vy and Enrique Maravi-Poma and Petrov, {Maxim S.} and Tooru Shimosegawa and Siriwardena, {Ajith K.} and Generoso Uomo and Whitcomb, {David C.} and Windsor, {John A.} and {Pancreatitis Across Nations Clinical Research and Education Alliance (PANCREA)} and {Abu Hilal}, M. and Abu-Zidan, {F. M.} and Acosta, {J. M.} and Ainsworth, {A. P.} and {Aizcorbe Garralda}, M. and H. Alagozlu and Al{\textquoteright}aref, {S. J.} and {Albeniz Arbizu}, E. and A. Alhajeri and Almeida, {I. C.} and Almeida, {J. L.} and H. Amano and Ammori, {B. J.} and B. Andersson and R. Andersson and A. Andr{\'e}n-Sandberg and Ardengh, {J. C.} and Arroyo-Sanchez, {A. S.} and M. Arvanitakis and Ashley, {S. W.} and G. Aygencel and Ayoub, {W. A.} and J. Baillie and M. Bala and Ball, {C. G.} and Baron, {T. H.} and Barreto, {S. G.} and M. Basaranoglu and Beger, {H. G.} and {Bernal Monterde}, V. and N. Bharwani and Bhasin, {D. K.} and Bong, {J. J.} and G. Botoi and T. Bruennler and E. Cairoli and Carter, {C. R.} and D. Cernea and Chari, {S. T.} and Charnley, {R. M.} and S. Chooklin and D. Cochior and C. Col and Conwell, {D. L.} and Correia, {M. I.} and Z. Dambrauskas and K. Darvas and {De Campos}, T. and {De Casasola}, {G. G.} and {De Waele}, {J. J.} and {Del Chiaro}, M. and {Delle Fave}, G. and E. De-Madaria and {Di Sebastiano}, P. and Diuzheva, {T. G.} and A. Duarte-Rojo and Fagenholz, {P. J.} and G. Farkas and {Farre Viladrich}, A. and {Fernandez-Del Castillo}, C. and H. Friess and Frossard, {J. L.} and V. Gandhi and Gardner, {T. B.} and B. Gloor and M. Gluk and Goltsov, {V. R.} and J. Guevara-Campos and Gumbs, {A. A.} and T. Hackert and G. Hauser and Horvath, {K. D.} and Howard, {T. J.} and H. Igarashi and O. Ioannidis and S. Jaber and James, {F. E.} and Jha, {R. K.} and D. Juneja and T. Kamisawa and P. Kandasami and M. Kantarcioglu and Kapoor, {V. K.} and T. Karakan and E. Kaya and A. Khaliq and S. Kiriyama and R. Kochhar and Konstantinou, {G. N.} and Kyl{\"a}np{\"a}{\"a}, {M. L.} and Lankisch, {P. G.} and {Laplaza Santos}, C. and J. Lata and A. Lepp{\"a}niemi and P. Levy and A. Lopez and {L{\'o}pez Camps}, V. and Lujano-Nicolas, {L. A.} and H. Lund and D. Lytras and {Macaya Redin}, L. and Machado, {M. C.} and {Macias Rodriguez}, {M. A.} and O. Mann and E. Maravi-Poma and M. Marincas and S. Marwah and E. Mas and Matheus, {A. S.} and R. Meier and D. Mennecier and P. Mentula and A. Mifkovic and R. Mofidi and Mole, {D. J.} and G. Morris-Stiff and J. Mossner and Muftuoglu, {M. A.} and Munsell, {M. A.} and Nathens, {A. B.} and V. Neri and C. N{\"o}jgaard and I. Nordback and C. Ocampo and A. Ol{\'a}h and J. Olejnik and O{\textquoteright}reilly, {D. A.} and A. Oria and J. Panek and Papachristou, {G. I.} and D. Parekh and Parks, {R. W.} and C. Passaglia and Pearce, {C. B.} and D. Pellegrini and M. Perez-Mateo and V. Pettila and R. Pezzilli and Pitchumoni, {C. S.} and S. Pongprasobchai and {Poves Prim}, I. and P. Puolakkainen and G. Pupelis and Radenkovic, {D. V.} and Rahman, {S. H.} and {Regidor Sanz}, E. and A. Repiso and L. Rodrigo and A. Rosseland and G. Rydzewska and {S{\'a}nchez-Izquierdo Riera}, {J. A.} and Savides, {T. J.} and M. Scaglione and A. Serrablo and E. Servin-Torres and I. Sethu and O. Sezgin and M. Shankar-Hari and Singer, {M. V.} and Sinha, {S. K.} and {Sjoberg Bexelius}, T. and Skipworth, {J. R.} and Soriano, {F. G.} and R. Sotoudehmanesh and Spanier, {B. W.} and B. Stabuc and W. Steinberg and C. Stroescu and Z. Szentkereszty and T. Takacs and T. Takada and K. Takeda and Y. Takeyama and W. Tang and K. Tanjoh and Tarnasky, {P. R.} and N. Teich and Tellado, {J. M.} and S. Tenner and A. Thomson and M. Tireli and Z. Tong and C. Triantopoulou and Uy, {M. C.} and {van Geenen}, {E. J.} and {Velasco Guardado}, A. and N. Vettoretto and Vollmer, {C. M.} and K. Wada and Warshaw, {A. L.} and Weinbroum, {A. A.} and Wilson, {J. S.} and M. Wittau and Wu, {B. U.} and Wysocki, {A. P.} and {Yan Quiroz}, E. and T. Yasuda and C. Yu and E. Zerem and X. Zhou and {Zubia Olazcoaga}, F. and Zyromski, {N. J.}",
year = "2012",
month = dec,
day = "1",
doi = "10.1097/SLA.0b013e318256f778",
language = "English",
volume = "256",
pages = "875--880",
journal = "Annals of Surgery",
issn = "0003-4932",
number = "6",
}