Pancreatitis is both vexing and fascinating. The spectrum of severity and complications is wide. Unfortunately, all too often it is not apparent on day one. Complications typically unfold, one organ system at a time, over several days. When admitting a patient with pancreatitis from the ER it is all but impossible to answer the question “Where will this patient be in four days?” Home? Or in the ICU on mechanical ventilation? The Ranson score, for example, requires assessment out to 48 hours in order to predict mortality. Since Ranson there have been many attempts to develop easier to use tools to assess severity and predict complications. One of the latest is the PASS. The PASS can predict severity on day one according to this report. This free full text article explains the score in more detail. My concern is that it is difficult to use and incorporates subjective components (numeric pain scale).