Table 1.
The severity scoring criteria of acute pancreatitis defined by the Japanese Ministry of Health, Labor and Welfare (2008)
| Prognostic factor | |
| Base excess ≤ -3 mEq/L or shock (systolic blood pressure < 80 mmHg) | |
| PaO2 ≤ 60 mmHg or respiratory failure (needing respirator) | |
| BUN ≥ 40 mg/dL (or Cr ≥ 2 mg/dL) or oliguria (< 400 mL/d even after fluid therapy) | |
| Elevation of LDH twice or more than upper normal limit | |
| Platelet count ≤ 100000/μL | |
| Serum calcium ≤ 7.5 mg/dL | |
| CRP ≥ 15 mg/dL | |
| Meeting 3 or more SIRS criteria (body temperature > 38 °C or < 36 °C, heart rate > 90/min, respiratory rate > 20/min or PaCO2 < 32 torr, WBC > 12000/μL or < 4000/μL or > 10% immature leukocyte) | |
| Age ≥ 70 yr | |
| Classification of CT grade by contrast-enhanced CT | |
| Factor 1: Extent of extrapancreatic inflammation | |
| To the anterior pararenal extraperitoneal space | 0 point |
| To the root of mesocolon | 1 point |
| Further than inferior pole of kidney | 2 points |
| Factor 2: Less-enhanced region of pancreas (divided into three segments; head, body and tail) | |
| Localized within one segment or limited to peripheral pancreas | 0 point |
| Occupies two segments | 1 point |
| Occupies more than two segments | 2 points |
| Sum of factor 1 and factor 2 ≤ 1 | grade 1 |
| Sum of factor 1 and factor 2 = 2 | grade 2 |
| Sum of factor 1 and factor 2 ≥ 3 | grade 3 |
Severe acute pancreatitis is defined as fulfilling 3 or more criteria of prognostic factors or revealing CT grade 2 or more. BUN: Blood urea nitrogen; Cr: Creatinine; CRP: C-reactive protein; CT: Computed tomography; LDH: Lactate dehydrogenase; SIRS: Systemic inflammatory response syndrome; WBC: White blood cells.