Consensus of primary care in acute pancreatitis in Japan

Table 2 Criteria for grading the severity of acute pancreatitis

Prognostic factors	Clinical signs	Laboratory data
Prognostic factor I (2 points for each positive factor)	Shock	BE ≤ -3 mEq/L
	Respiratory failure	Ht ≤ 30% (after hydration)
	Mental disturbance	BUN ≥ 40 mg/dL or
	Severe infection	creatinine ≥ 2.0 mg/dL
	Hemorrhagic diathesis
Prognostic factor II (1 point for each positive factor)		PaO2 ≤ 60 mmHg (room air) FBS ≥ 200 mg/dL Total protein ≤ 60 g/L LDH ≥ 700 IU/L Ca ≤ 7.5 mg/dL Prothrombin time ≥ 15 s Platelet count ≤ 1 × 105 /mm3 CT grade IV or V1
Prognostic factor III	SIRS score ≥ 3 (2 points) Age≥ 70 yr (1 point)

BE: Base excess, Ht: Hematocrit, BUN: Blood urea nitrogen; FBS: Fasting blood sugar; LDH: Lactate dehydrogenase; SIRS: Systemic inflammatory response syndrome.

¹CT grade IV or V: Presence of diffuse and uneven density in the pancreatic parenchyma or the presence of inflammatory changes extending beyond the border of the pancreas. Severity score: Sum of the points for the positive prognostic factors is defined as the severity score. Standardized criteria: Severe: Presence of more than one prognostic factor I, and/or the presence of more than two prognostic factor II (severity score ≥ 2 points). Moderate: Presence of one prognostic factor II (severity score = 1 point). Mild: Acute pancreatitis without prognostic factor I or II (severity score = 0 point).