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The Pancreatitis Outcome Prediction (POP) Score: A New Prognostic index for patients with severe acute pancreatitis Harrison, David A, D’Amico, Giovanna, Singer, Mervyn. “Critical Care Med 2007 Vol.35 No. 7” Presenter: 郭妍伶 August 13, 2007 Introduction Pancreatitis severity ranges from mild to MOF with sepsis and necrotizing or hemorrhagic forms Overall mortality: 10-15% Biphasic time to death Prognostic scoring systems Atlanta classification Ranson Score Glasgow Score Modified Glascow Atlanta Classification ACUTE PANCREATITISAcute pancreatitis is an acute inflammatory process of the pancreas, with variable involvement of other regional tissues or remote organ systems. SEVERE ACUTE PANCREATITISSevere acute pancreatitis is associated with organ failure and/or local complications such as necrosis (with infection), pseudocyst or abscess. Most often this is an expression of the development of pancreatic necrosis, although patients with oedematous pancreatitis may manifest clinical features of a severe attack. MILD ACUTE PANCREATITISMild acute pancreatitis is associated with minimal organ dysfunction and an uneventful recovery. The predominant pathological feature is interstitial oedema of the gland. ACUTE FLUID COLLECTIONSAcute fluid collections occur early in the course of acute pancreatitis, are located in or near the pancreas, and always lack a wall of granulation of fibrous tissue. PANCREATIC NECROSIS AND INFECTED NECROSISPancreatic necrosis is a diffuse or focal area(s) of non-viable pancreatic parenchyma, which is typically associated with peripancreatic fat necrosis. The onset of infection results in infected necrosis, which is associated with a trebling of the mortality risk. ACUTE PSEUDOCYSTAn acute pseudocyst is a collection of pancreatic juice enclosed in a wall of fibrous or granulation tissue that arises following an attack of acute pancreatitis. Formation of a pseudocyst requires four or more weeks from the onset of acute pancreatitis. PANCR