Skip to main content

Table 1 Japanese severity scoring system for acute pancreatitis of the Ministry of Health, Labour and Welfare of Japan (2008 revision) a

From: Continuous regional arterial infusion for acute pancreatitis: a propensity score analysis using a nationwide administrative database

Scoring system

Basis for score

Prognostic factor score (one point for each factor)



Base excess less than or equal to -3 mEq/L or shock (systolic blood pressure below 80 mmHg)


PaO2 ≤60 mmHg (room air) or respiratory failure (respiratory assistance needed)


BUN ≥40 mg/dl or (or creatinine ≥2.0 mg/dl) or oliguria (daily urine output <400 ml even after intravenous fluid resuscitation)


LDH at or above twice the upper limit of normal


Platelet count ≤100,000/mm3


Serum calcium ≤7.5 mg/dl


CRP ≥15 mg/dl


Number of positive measures in SIRS criteria ≥3


Age ≥70 years

CT grade based on contrast-enhanced CT



Extrapancreatic progression of inflammation


Anterior pararenal space, zero points


Root of mesocolon, one point


Beyond lower pole of kidney, two points


Hypoenhanced lesion of the pancreas


Pancreas conveniently divided into three segments (head, body and tail).


Localized in each segment or surrounding only the pancreas, zero points


Extends to two segments, one point


Occupies two whole segments or more, two points


Factors 1 + 2 = total score


Total score = 0 or 1, grade 1


Total score = 2, grade 2


Total score = 3 or more, grade 3

Assessment of severity

If prognostic factor score is ≥3 or CT grade is ≥2, acute pancreatitis is considered severe.

  1. aBUN, Blood urea nitrogen; CRP, C-reactive protein; CT, Computed tomography; LDH, Lactate dehydrogenase; PaO2, partial pressure of oxygen in blood; SIRS, Systemic inflammatory response syndrome. Measures within the SIRS criteria include body temperature above 38°C or less than 36°C, heart rate more than 90 beats/min, respiratory rate more than 20 breaths/min or partial pressure of carbon dioxide in blood less than 32 torr, as well as white blood cell count above 12,000 cells/mm3, less than 4,000 cells/mm3 or greater than 10% immature (band) forms. The 2008 revision of the Japanese severity scoring system is contained in [22].