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Modified Marshall scoring system for organ dysfunction

Organ system	Score
Organ system	0	1	2	3	4
Respiratory (PaO₂/FiO₂)	>400	301-400	201-300	101-200	≤101
Renal*
(serum creatinine, micromol/L)	≤134	134-169	170-310	311-439	>439
(serum creatinine, mg/dL)	<1.4	1.4-1.8	1.9-3.6	3.6-4.9	>4.9
Cardiovascular (systolic blood pressure, mmHg)^¶	>90	<90, fluid responsive	<90, not fluid responsive	<90, pH <7.3	<90, pH <7.2
For nonventilated patients, the FiO₂ can be estimated from below:
Supplemental oxygen (L/min)	FiO₂ (percent)
Room air	21
2	25
4	30
6-8	40
9-10	50

A score of 2 or more in any system defines the presence of organ failure.

* 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 micromol/L or ≥1.4 mg/dL.
¶ Off inotropic support.

Reproduced with permission from: Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis - 2012: revisions of the Atlanta classification and definitions by international consensus. Gut 2013; 62:102. BMJ Publishing Group Ltd. Copyright © 2013.

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