Severe Acute Pancreatitis
| Risk Factors for Severity |
• Age >60 years • Obesity, BMI >30 • Comorbid disease (Charlson Comorbidity Index) |
| Markers of Severity at Admission or Within 24 h |
• SIRS—defined by presence of 2 or more criteria: • Core temperature <36° or>38°C • Heart rate >90 beats/min • Respirations >20/min or Pco2<32 mmHg • White blood cell count >12,000/µL, <4000/µL, or 10% bands • APACHE II • Hemoconcentration (hematocrit >44%) • Admission BUN (>22 mg/dL) • BISAP Score - (B) BUN >25 mg/dL - (I) Impaired mental status - (S) SIRS: ≥2 of 4 present - (A) Age >60 years - (P) Pleural effusion • Organ failure (Modified Marshall Score) • Cardiovascular: systolic bp <90 mmHg, heart rate >130 beats/min • Pulmonary: Pao2<60 mmHg • Renal: serum creatinine >2.0 mg% |
| Markers of Severity During Hospitalization |
• Persistent organ failure • Pancreatic necrosis |
Abbreviations: APACHE II, Acute Physiology and Chronic Health Evaluation II; BMI, body mass index; BISAP, Bedside Index of Severity in Acute Pancreatitis; SIRS, systemic inflammatory response syndrome.