Changes in the Treatment of Severe Acute Pancreatitis in a Japanese Emergency Room After the Implementation of the JPN Guidelines

DOI 3 References
  • Tsuji Yoshihisa
    Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine
  • Yamamoto Hiroshi
    Department of Gastroenterology, Kurashiki Central Hospital

Bibliographic Information

Other Title
  • 「急性膵炎の診療ガイドライン」によって診療行為がどう変わったか？「急性膵炎の診療ガイドライン」前後における市中病院の変化
Published
2007
Resource Type
journal article
DOI
  • 10.11231/jaem.27.463
Publisher
Japanese Society for Abdominal Emergency Medicine

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Description

Background & Aims : In spite of treatment advances, the mortality rate for severe acute pancreatitis remains high. In July 2003, the JPN (define) guidelines were published in an attempt to reduce the mortality rate in Japan. These practical guidelines have been useful and popular in Japan. Here, we examined the changes in a Japanese emergency room after the adoption of the JPN guidelines. Patients & Methods : The clinical records of 209 consecutive patients with a diagnosis of acute pancreatitis who were treated at Kurashiki Central Hospital either 24 months before or after the publication of the JPN guidelines were retrospectively examined. The number of patients, the number of patients who were transported from another hospital, the period between disease onset and hospital admission, the severity, the length of the hospital stay, the mortality rate, and the cost of treatment were then compared between these two treatment periods. Results : Eighty patients with acute pancreatitis were treated at our hospital in the 24-month period before the JPN guidelines were published, whereas 129 patients were treated in a 24-month period after the guidelines were published (P<0.05). The number of patients transported from other hospitals, severity, length of hospital stay, and treatment cost all increased after the implementation of the JPN guidelines (P<0.05). On the other hand, the period between disease onset and hospital admission was shorted (P<0.05), and the mortality rate decreased from 17.6% to 4.1%. Conclusion : A large number of cases were transported to our hospital both before and after the implementation of the JPN guidelines, but the period between disease onset and hospital admission was shortened and the mortality rate decreased after guideline implementation. Early diagnosis, early transport, and the early recognition of indications for intensive care may have contributed to the reduction in the mortality rate for severe acute pancreatitis.

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