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Currently available scoring systems are shown in Table 4.1. Of these, SIRS and the Bedside Index of Severity in Acute Pancreatitis (BISAP) are the most commonly used and easy to calculate (Table 4.1). Using SIRS criteria to risk‐stratify has advantages over BISAP score because it does not need a chest X‐ray to calculate, and its predictive performance is fairly comparable to BISAP. One in two patients meeting all four criteria for SIRS on admission required transfer to the intensive care unit (ICU) within the first week in a prospective study of 252 patients with AP [23]. Other systems are more cumbersome to calculate (APACHE‐II) or rely on data availability over 48 hours (Ranson). The Harmless Acute Pancreatitis Score aims to identify patients predicted to have a mild course, with high sensitivity and specificity [77,78]. The Pancreatitis Activity Scoring System (PASS) score (see Table 4.1) is the most recently developed score [26]. While originally designed and developed to measure “activity” of AP, the authors also recently tested its predictive function [27].

Table 4.3 Components of computed tomography severity index (CTSI) and modified CTSI.