Staging acute pancreatitis: where are we now?

Acute pancreatitis is a potentially lethal disease in about 20% of all the cases. Early identification of those patients with the severe type of the disease is of a great importance as intensive care treatment and other therapeutic manipulations can apply to alter the clinical course, and finally the outcome. Therefore, there is a need for precise criteria for severity prediction--that can be easily applied with high accuracy and sensitivity--very early after the onset of acute pancreatitis. Although no 'ideal' predictor exists so far, APACHE II score, C-reactive protein and the trypsinogen activation peptide, could be used in clinical practice. Other prognostic markers such as interleukin-6 and interleukin-8 could be useful in the near future, as soon as proper assays will be available. Furthermore, the development of logistic models, based on different parameters concerning the severity of the individual patient, is another option for the future.