Japanese Severity Scale (JSS) for Acute Pancreatitis

 

Prognostic factor I (correspond to organ failures):

(1) shock

(2) respiratory failure

(3) mental disturbance

(4) severe infection

(5) coagulopathy with bleeding

(6) base excess <= -3 mmol/L

(7) hematocrit < 30% after hydration (resuscitation)

(8) BUN level >= 40 mg/dL OR serum creatinine >= 2.0 mg/dL

 

Prognostic factor II:

(1) serum calcium <= 7.5 mg/dL

(2) blood glucose >= 200 mg/dL

(3) PaO2 <= 60 mm Hg on room air (FIO2 0.21)

(4) serum LDH >= 700 IU/L

(5) total protein <= 6.0 g/dL

(6) prothrombin time >= 15 seconds

(7) platelet count <= 100,000 per µL

(8) CT grade IV or V

 

Prognostic factor III:

(1) systemic inflammatory response syndrome (SIRS) score >= 3

(2) age >= 70 years

Findings	Grade of Pancreatitis
>= 1 Prognostic Factor I	severe
>= 2 Prognostic Factor II	severe
1 Prognostic Factor II	moderate
none from either groups I or II	mild

 

total score =

= (2 * (number of items from PF I)) + (number of items from PF II) + (2 if SIRS >=3) + (1 if age >= 70)

 

Interpretation:

• minimum total score: 0

• maximum total score: 27

• The higher the total score the more severe the pancreatitis.

 

Total Score	Severity Stage
0	0
1	1
2 to 8	2
9 to 14	3
15 to 27	4

 

Limitations:

• The methodology and reference ranges for some of the tests are not specified.