Bank et al listed clinical criteria associated with poor prognosis in patients with acute pancreatitis. This can help identify those patients who may require more intensive care.
Organ System
Finding
cardiac
severe hypotension or shock
tachycardia > 130 beats per minute
arrhythmia
ECG changes
pulmonary
dyspnea
rales, pulmonary edema
PaO2 < 60 mm Hg
adult respiratory distress syndrome
renal
urine output < 50 mL/h
increasing BUN and/or creatinine
metabolic
low or falling calcium
low or falling pH
decreased albumin
hematologic
falling hematocrit
DIC (low platelet counts, fibrin split products)
neurological
irritability
confusion
localizing signs on neurological examination
hemorrhagic pancreatitis
Grey-Turner or Cullen signs; evidence on peritoneal tap
tense distension (abdomen)
severe ileus, fluid 2+
number of Bank's criteria =
= SUM(findings present)
Interpretation:
• minimum number = 0
• maximum number = 20
• Severe disease (potentially lethal) may occur if 1 or more of these findings is present.
To read more or access our algorithms and calculators, please log in or register.
