Modified Marshall Score

Q: In the Modified Marshall scoring system for organ dysfunction in acute pancreatitis, deterioration of which of the following organs is included? - select one

A) Gall Bladder

B) Liver

C) Pancrease

D) Kidney

E) Spleen

Answer: D

The Modified Marshall Score in acute pancreatitis objectively assesses the level of organ dysfunctions. It has three main components:

• PaO2/FiO2
• serum creatinine, and
• systolic blood pressure

 Clinical significance: Patients with worsening Modified Marshall scores for organ dysfunction may qualify for plasmapheresis, though the decision to perform plasmapheresis should be made in conjunction with other clinical and laboratory data.

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References:

1.  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. 

2. Ling CHY, Bond R, East S, Young R. Modified Marshall Score: An Underutilised Prognostication Tool for Acute Pancreatitis. Cureus. 2025 Nov 14;17(11):e96842. doi: 10.7759/cureus.96842. PMID: 41356937; PMCID: PMC12677363.

3. Hartmann J, Werge M, Schmidt PN, Hansen EF, Pedersen UG, Kristiansen KT, Gluud LL, Novovic S. Modified Marshall Score Predicts Mortality in Patients With Walled-off Pancreatic Necrosis Treated in an Intensive Care Unit. Pancreas. 2019 Oct;48(9):e68-e70. doi: 10.1097/MPA.0000000000001409. PMID: 31609936.

4. Abu Omar Y, Attar BM, Agrawal R, Randhawa T, Majeed M, Wang Y, Simons-Linares CR, Wang Y. Revised Marshall Score: A New Approach to Stratifying the Severity of Acute Pancreatitis. Dig Dis Sci. 2019 Dec;64(12):3610-3615. doi: 10.1007/s10620-019-05719-y. Epub 2019 Jul 8. PMID: 31286346.