Commentaries
A simple index on the day of admission which predicts outcome in acute pancreatitis
Correspondence to:
Professor Peter Layer, Department of Medicine, Israelitic Hospital, Orchideenstieg 14, D-22297 Hamburg, Germany; layer@ik-h.de
| The first 150 words of the full text of this article appear below. |
Severe pancreatitis is typically associated with (multi-) organ failure originating from local and systemic complications, and requires intensive, often specialised, interdisciplinary management including complex interventions. Severity originates from a "double hit" mechanism, involving an initial phase dominated by the systemic inflammatory response syndrome (SIRS); and, often after transient improvement, subsequent deterioration due to secondary septic complications driven by infected necrosis or pseudocysts. Hence, a prolonged course with consumption of considerable resources is common, and mortality is still substantial. As prevention or early and effective treatment of complications and organ failure count among the most important management aims, it is therefore pivotal to anticipate severe disease with reasonable accuracy. On the other hand, most patients with acute pancreatitis have a mild, uneventful and uncomplicated course, characterised by absence of organ failure or deaths; they can be treated on a peripheral ward and discharged home within a few days. In these patients,
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