Scoring system | Basis for score |
---|---|
Prognostic factor score (one point for each factor) | |
1 | Base excess less than or equal to -3 mEq/L or shock (systolic blood pressure below 80 mmHg) |
2 | PaO2 ≤60 mmHg (room air) or respiratory failure (respiratory assistance needed) |
3 | BUN ≥40 mg/dl or (or creatinine ≥2.0 mg/dl) or oliguria (daily urine output <400 ml even after intravenous fluid resuscitation) |
4 | LDH at or above twice the upper limit of normal |
5 | Platelet count ≤100,000/mm3 |
6 | Serum calcium ≤7.5 mg/dl |
7 | CRP ≥15 mg/dl |
8 | Number of positive measures in SIRS criteria ≥3 |
9 | Age ≥70 years |
CT grade based on contrast-enhanced CT | |
1 | Extrapancreatic progression of inflammation |
Anterior pararenal space, zero points | |
Root of mesocolon, one point | |
Beyond lower pole of kidney, two points | |
2 | 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. |