Ranson criteria


The Ranson criteria form a clinical prediction rule for predicting the prognosis and mortality risk of acute pancreatitis. They were introduced in 1974 by the English-American pancreatic expert and surgeon Dr. John Ranson.

Usage

A score of 3 or more indicates severe acute pancreatitis. This can cause organ failure, necrosis, infected necrosis, pseudocyst, and abscess. If diagnosed with severe acute pancreatitis, people will need to be admitted to a high-dependency unit or intensive care unit.

Acute pancreatitis not secondary to gallstones

At admission:
  1. Blood glucose > 11.11 mmol/L
  2. Age > 55 years
  3. Serum LDH > 350 IU/L
  4. Serum AST > 250 IU/L
  5. WBC count > 16000 cells/mm3
Within 48 hours:
  1. Serum calcium < 2.0 mmol/L
  2. Hematocrit decreased by > 10%
  3. Oxygen
  4. BUN increased by 1.8 or more mmol/L after IV fluid hydration
  5. Base deficit > 4 mEq/L
  6. Sequestration of fluids > 6 L

Acute pancreatitis secondary to gallstones

At admission:
  1. Glucose > 220 mg/dl
  2. Age > 70 years
  3. LDH > 400 IU/L
  4. AST > 250 IU/ 100 ml
  5. WBC count > 18000 cells/mm3
Within 48 hours:
  1. Serum calcium < 8 mg/dL
  2. Hematocrit decreased by > 10%
  3. Base deficit > 4 mEq/L
  4. BUN increased by > 2 mg/dL
  5. Sequestered fluid > 4L

Alternatives

Alternatively, pancreatitis severity can be assessed by any of the following:

Interpretation

  • If the score ≥ 3, severe pancreatitis likely.
  • If the score < 3, severe pancreatitis is unlikely
Or
  • Score 0 to 2 : 2% mortality
  • Score 3 to 4 : 15% mortality
  • Score 5 to 6 : 40% mortality
  • Score 7 to 8 : 100% mortality