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September 15, 2004

Severe Acute Pancreatitis—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(11):1305. doi:10.1001/jama.292.11.1305-c

In Reply: Dr Piwinski has correctly stated the limitation of Ranson's criteria in the assessment of severity of acute pancreatitis and believes that the prognostic system proposed by Rabeneck et al1 is more useful. In our review, we cited the scoring systems of Ranson, Imrie, APACHE II, and Balthazar because these have been validated and extensively used in the literature. Space constraints for a short review did not permit us to discuss in detail the acknowledged imperfections and shortcomings of all of these systems, although we did note that Ranson's criteria system has the disadvantage of a 48-hour delay for completion.

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