this patient with sever acute pancreatitis also has several risk factors for severe disease based on the presence of three of four Systemic Inflammatory Response Syndrome (SIRS) criteria (pulse rate >90/min, leukocyte count >12,000/µL [12 × 109/L], and respiration rate >20/min) and a blood urea nitrogen level greater than 23 mg/dL (8.2 mmol/L).