A patient develops post-ERCP pancreatitis. Serum amylase measured 24 hours post-ERCP is 1400 U/L, and the patient has severe epigastric pain requiring hospital admission. Which scoring system best predicts the severity of acute pancreatitis at 48 hours of admission?
- A Modified Glasgow (Imrie) score
- B APACHE II score
- C Ranson's criteria at 48 hours ✓
- D BISAP score
Explanation
Ranson's criteria remain the classic scoring system specifically designed for acute pancreatitis, with 5 parameters at admission and 6 parameters at 48 hours (total 11 criteria). A score ≥3 at 48 hours predicts severe pancreatitis. APACHE II is validated throughout admission but is more complex. BISAP uses 24-hour data. The Modified Glasgow score has 8 criteria at 48 hours and is used in UK practice. Ranson's 48-hour criteria are classically tested in Indian PG examinations because they specifically measure organ failure (base deficit, fluid sequestration, BUN rise, hematocrit fall, PaO2, calcium).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.