Patient selection acute pancreatitis
Parameters:
(1) number of organ system failures (modified Marshall >= 2 or SOFA score >= 2)
(2) tolerance to a solid diet
(3) number of criteria for systemic inflammatory response syndrome (SIRS), out of 4
(4) 10-cm VAS abdominal pain score, from 0 (none) to 10 (extreme)
(5) mg of intravenous morphine equivalent for a 12 hour time period
|
Parameter
|
Finding
|
Points
|
|
number of organ failures
|
|
100 * (number)
|
|
tolerance of a solid diet
|
yes
|
0
|
|
|
no
|
40
|
|
number of SIRS criteria
|
|
25 * (number)
|
|
abdominal pain
|
|
5 * (VAS score)
|
|
IV morphine in mg
|
|
5 * (dose)
|
where:
• The 4 SIRS criteria: heart rate > 90 bpm; respiratory rate > 20 bpm OR PaCO2 < 32 mm Hg; temperature < 36°C or > 38°CWBC count < 4,000 or > 12,000 per µL.
• Organ failures measured for respiratory, circulatory and renal.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: over 500; affected by dose of morphine
• The higher the score the greater the activity of the pancreatitis.
• A high score is associated with complications and early readmission.
