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Modified Marshall Scoring System for Organ Dysfunction

(For early phase of acute pancreatitis (first week ± second week of disease).)

Respiratory

Partial pressure of oxygen, PaO₂

Fraction of inhaled oxygen, FiO₂ (%)

For non-ventilated patients, enter FiO₂ value for the supplemental oxygen levels:

21 (Room air)
25 (2 L/minute)
30 (4 L/minute)
40 (6-8 L/minute)
50 (9-10 L/minute)

PaO₂/FiO₂ (mmHg)

Renal (serum creatinine)
(N.B. A score for patients with pre-existing chronic renal failure depends on the extent of further deterioration of baseline renal function. No formal correction exists for a baseline serum creatinine >= 134 μmol/L or >= 1.4 mg/dL.)

Cardiovascular (off inotropic support)

Modified Marshall scores for respiratory system

Modified Marshall scores for renal system

Modified Marshall scores for cardiovascular system

The patient has

organ failure.

Formula

Scoring table

A score of 2 or more in any system defines the presence of organ failure.
If organ failure affects more than one organ system, it is termed multiple organ failure (MOF).

Grades of severity by Modified Marshall scoring system

Mild acute pancreatitis
- No organ failure
Moderately severe acute pancreatitis
- Organ failure that resolves within 48 hours (transient organ failure)
Severe acute pancreatitis
- Persistent organ failure (>48 hours)

Reference

Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2012;62(1):102-111. doi:10.1136/gutjnl-2012-302779