Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan

Table 1 The severity scoring system of acute pancreatitis of the Japanese Ministry of Health, Labour and Welfare (2008)[15]

Prognostic factors (1 point for each factor)
Base excess ≤ 3 mEq/L or shock (systolic blood pressure < 80 mmHg)
PaO2 ≤ 60 mmHg (room air) or respiratory failure (respirator management is needed)
BUN ≥ 40 mg/dL (or Cr ≥ 2.0 mg/dL) or oliguria (daily urine output <400 mL even after fluid replacement)
LDH ≥ 2 times of upper limit of normal
Platelet count ≤ 100000/mm3
Serum Ca ≤ 7.5 mg/dL
CRP ≥ 15 mg/dL
Number of positive measures in SIRS criteria ≥3
Age ≥ 70 yr
CT Grade by CECT
Extra-pancreatic progression of inflammation
Anterior pararenal space	0 point
Root of mesocolon	1 point
Beyond lower pole of kidney	2 points
Hypo-enhanced lesion of the pancreas
The pancreas is conveniently divided into three segments (head, body, and tail).
Localized in each segment or only surrounding the pancreas	0 point
Covers 2 segments	1 point
Occupies entire 2 segments or more	2 points
1 + 2 = total scores
Total score = 0 or 1	Grade 1
Total score = 2	Grade 2
Total score = 3 or more	Grade 3
Assessment of severity
(1) If prognostic factors are scored as 3 points or more, or (2) If CT Grade grade is judged as Grade grade 2 or more, the severity grading is evaluated to be as ‘‘severe’’.
Measures in SIRS diagnostic criteria: (1) Temperature > 38 °C or < 36 °C; (2) Heart rate > 90 beats/min; (3) Respiratory rate > 20 breaths/min or PaCO2 < 32 torr; and (4) WBC > 12000 cells/mm3, < 4000 cells/mm3, or > 10% immature (band) forms.

WBC: White blood cell; CT: Computed tomography; LDH: lactate dehydrogenase; CRP: C-reaction protein.