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September 15, 2004

Severe Acute Pancreatitis

Author Affiliations

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

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

To the Editor: Using Ranson's criteria to forecast outcome in patients with pancreatitis would indicate that a 56-year-old individual with a glucose level of 201 mg/dL (11.2 mmol/L) and a white blood cell count of 16.1 ×103/µL has the same risk for adverse outcome as one who develops a PO2of less than 60 mm Hg, has a decrease in hematocrit by 10%, and sequesters 6 L of abdominal fluid in 48 hours.1 I would call into question the validity of a scoring system that equally weights these disparate factors.