BACKGROUND: Early assessment of the severity of acute pancreatitis is essential to the proper management of the disease. It is dependent on the criteria of the Atlanta classification system.
DATA SOURCES: PubMed search of recent relevant articles was performed to identify information about the severity and prognosis of acute pancreatitis.
RESULTS: The scoring systems included the Ranson's or Glasgow's criteria ≥3, the APACHE II classification system ≥8, and the Balthazar's criteria ≥4 according to the computed tomography enhanced scanning findings. The single factors on admission included age >65 years, obesity, hemoconcentration (>44%), abnormal chest X-ray, creatinine >2 mg/dl, C-reactive protein >150 mg/dl, procalcitonin >1.8 ng/ml, albumin <2.5 mg/dl, calcium <8.5 mg/dl, early hyperglycemia, increased intra-abdominal pressure, macrophage migration inhibitory factor, or a combination of IL-10 >50 pg/ml with calcium <6.6 mg/dl.
CONCLUSION: The prediction of the severity of acute pancreatitis is largely based on well defined multiple factor scoring systems as well as several single risk factors.