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JPN Guidelines for the management of acute pancreatitis: severity assessment of acute pancreatitis
Author(s) -
Hirota Masahiko,
Takada Tadahiro,
Kawarada Yoshifumi,
Hirata Koichi,
Mayumi Toshihiko,
Yoshida Masahiro,
Sekimoto Miho,
Kimura Yasutoshi,
Takeda Kazunori,
Isaji Shuji,
Koizumi Masaru,
Otsuki Makoto,
Matsuno Seiki
Publication year - 2006
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-005-1049-1
Subject(s) - acute pancreatitis , medicine , christian ministry , pancreatitis , apache ii , severity of illness , intensive care medicine , scoring system , welfare , emergency medicine , intensive care unit , political science , law , philosophy , theology
This article addresses the criteria for severity assessment and the severity scoring system of the Ministry of Health and Welfare of Japan; now the Japanese Ministry of Health, Labour, and Welfare (the JPN score). It also presents data comparing the JPN score with the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Ranson score, which are the major measuring scales used in the United States and Europe. The goal of investigating these scoring systems is the achievement of earlier diagnosis and more appropriate and successful treatment of severe or moderate acute pancreatitis, which has a high mortality rate. This article makes the following recommendations in terms of assessing the severity of acute pancreatitis: Severity assessment is indispensable to the selection of proper initial treatment in the management of acute pancreatitis (Recommendation A). Assessment by a severity scoring system (JPN score, APACHE II score) is important for determining treatment policy and identifying the need for transfer to a specialist unit (Recommendation A). C‐reactive protein (CRP) is a useful indicator for assessing severity (Recommendation A). Contrast‐enhanced computed tomography (CT) scanning and contrast‐enhanced magnetic resonance imaging (MRI) play an important role in severity assessment (Recommendation A). A JPN score of 2 or more (severe acute pancreatitis) has been established as the criterion for hospital transfer (Recommendation A). It is preferable to transfer patients with severe acute pancreatitis to a specialist medical institution where they can receive continuous monitoring and systemic management.