Cw. Imrie, CLASSIFICATION OF ACUTE-PANCREATITIS AND THE ROLE OF PROGNOSTIC FACTORS IN ASSESSING SEVERITY OF DISEASE, Schweizerische medizinische Wochenschrift, 127(19), 1997, pp. 798-804
Clinical assessment of acute pancreatitis by experts is as accurate as
any of the individual approaches which have been recommended. What is
important in a hospital setting is for one or more of these systems t
o be applied in individual hospitals so that forewarning is given, esp
ecially to the less experienced clinicians, of the patient who is like
ly to run into difficulties and requires high dependency or intensive
care. One practical approach which can be personally recommended is to
employ the Glasgow scoring system plus C-reactive protein levels and
also to take into account body mass index. Any patient with three posi
tive Glasgow factors, or CRP >150 mg/1 or BMI >30 kg/m(2) has severe a
cute pancreatitis. More refined systems may ultimately be developed bu
t we are still some way from a single substance in blood or urine bein
g easily and cheaply measured and representing an accurate prognostic
indicator of severe acute pancreatitis. Part of the journey has been c
ompleted but there is still considerable potential to make the rest of
the journey an improvement for both clinicians and patients.