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. 2020 Mar 26;2020(3):CD010582. doi: 10.1002/14651858.CD010582.pub2
Criteria Predictors
Modified Atlanta criteria 2012 (Banks 2012) Mild acute pancreatitis
No organ failure and no local or systemic complications
Moderately severe acute pancreatitis
Organ failure that resolves within 48 hours (transient organ failure) and/or local/systemic complications without persistent organ failure
Severe acute pancreatitis
Persistent organ failure (> 48 hours) – single or multiple
Atlanta criteria 1992 (Bradley 1993) Early prognostic signs: Ranson's > 3; APACHE‐11 score > 8
Organ failure and/or
Local complications: necrosis, abscess, pseudocyst
UK guidelines (2005) (UK 2005) Severity: Atlanta 1992
Prediction of severity:
  • Baseline: initial impression of severity, BMI > 30, pleural effusion, APACHE‐II > 8

  • On follow‐up (24 hours and 48 hours): clinical impression, APACHE‐II > 8, CRP > 150, Glasgow score ≥ 3, organ failure

Ranson’s score/criteria (Ranson 1974) Baseline: age > 55 years, WBC count > 16,000/mm3, glucose > 200 mg/dL, LDH > 350U/L, AST > 250 U/L
During initial 48 hours: HCT decrease of > 10 % increase in volume ; BUN increase of > 5 mg/dL; Ca2+< 8 mg/dL, PaO2 < 60 mmHg, base excess < 4 mEq/L; fluid sequestration > 6 L
Glasgow score/criteria
(Blamey 1984)
  • PaO2 < 7.9 kPa

  • Age > 55 years

  • Neutrophils > 15 X 109/L

  • Calcium < 2 mmol/L

  • Renal function: urea > 16 mmol/L

  • Enzymes LDH > 600 IU/L

  • Albumin < 32 g/L (serum)

  • Sugar (blood glucose) > 10 mmol/L

APACHE II (Knaus 1985) Combination of acute physiology score, age and chronic health points
CTSI (CT severity index) (Balthazar 1990) Based on CT grade (Balthazar Ranson grading system) and CT evidence of necrosis
Determinant‐based classification (DBC) (Dellinger 2012) Mild acute pancreatitis
No organ failure AND no (peri)pancreatic necrosis
Moderate acute pancreatitis
Transient organ failure AND/OR sterile (peri)pancreatic necrosis
Severe acute pancreatitis
Persistent organ failure OR infected (peri) pancreatic necrosis
Critical acute pancreatitis
Persisent organ failure AND infected (peri) pancreatic necrosis