- A number of systems exist to identify severity and prognosticate pancreatitis
- Considered advantageous over clinical judgement alone
- Useful in determining optimum location of care
- Limitations exist with many of the scoring systems:
- Cumbersome to complete
- Require 48 hours to gather variables for some scores
- Lack accuracy in early stages
- Limited clinical value
Classification Systems
Atlanta Criteria (1)
- Divides pancreatitis in to two pathophysiological types:
- Interstitial oedematous pancreatitis
- Necrotising pancreatitis
- Classifies severity as mild, moderate and severe
- Determined by presence of local features and organ failure
Prognostic Scoring Systems
Disease Specific
Clinical
- Ransoms: (1)
- Originally designed for gallstone-induced pancreatitis
- Uses age, nine laboratory parameters plus fluid requirements to calculate a score over 48 hours
- A score of >3 at 48 hours indicates the presence of severe pancreatitis
- Glasgow-Imrie: (1)
- Requires 48 hours to complete
- Uses age and seven laboratory parameters to predict severe pancreatitis
- BISAP (1)
Radiological
- Balthazar CT grade (1)
Non-Specific
- APACHE II (1)
- A score of >8 at 24 hours defines severe acute pancreatitis