Severity Scores for Acute Pancreatitis : Mnemonics

Modified Glasgow-Imrie Score

Severe pancreatitis likely: 3 or more of the following within 48 hours of symptom onset

MnemonicCriteriaPositive when
PPaO2<60 mmHg
AAge>55 years
NNeutrophils (WBC)>15,000/
CCalcium<2 mmol/l
RRFT (Urea)>16 mmol/l
EEnzyme (LDH/AST)LDH >600 units/l
AST >200 units/l
AAlbumin<32 gm/l
SSugar (Glucose)>10 mmol/l
pancreatitis severity scores

Ranson’s criteria

Severe pancreatitis likely: 3 or more

1. At Presentation:

MnemonicCriteriaNon gallstone+ for gall stoneGall stone
AAge>55 yrs15>70 yrs
GoodGlucose>200 mg/dl20>220 mg/dl
LLDH>350 U/l50>400 U/l
AAST>250 U/l0>250 U/l

After 48 hours:

MnemonicCriteriaNon gallstoneAdd or SubtractGallstone
AArterial pO2<60 mmHg0<60 mmHg
BBUN increase>5 mg/dl-3>2 mg/dl
CCalcium<8 mg/dl0<8 mg/dl
DeDeficit base>4 mEq/l+1>5 mEq/l
FgFluid requirement>6 L-2>4 L
HHCt drop>10%0>10%

BISAP (Bedside Index for Severity in Acute Pancreatitis) score

Severe pancreatitis likely: 3 or more at the time of admission

MnemonicCriteriaPositive when
BBUN>25 mg/dl
IImpaired mental statusPresent
AAge>60 years
PPleural effusionPresent

HAPS (Harmless Acute Pancreatitis Score)

Severe pancreatitis likely: 1 or more

MnemonicCriteriaPositive when
APAbdominal Peritonism (Rebound tenderness)Present
SSerum creatinine≥2 mg/dL

BALI score

Severe pancreatitis likely: 3 or more

MnemonicCriteriaPositive when
BBUN≥25 mg/dl
AAge≥65 years
LLDH≥300 U/l
IIL-6≥300 pg/ml

CT Severity Index (CTSI)

CTSI = Balthazar grade + Necrosis score

Severe pancreatitis likely: 7 or more

Balthazar gradeCT appearancePoints
AAll normal0
BBulky (edematous) pancreas1
CChanges (inflammatory – pancreatic +/- peripancreatic)2
DDefinitely one fluid collection3
EExtensive extrapancreatic fluid (more than 1) or gas collection4
Necrosis percentagePoints

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