Ranson criteria

Ranson criteria
Purpose	assess mortality risk of acute pancreatitis

TheRanson criteriaform aclinical prediction rulefor predicting the prognosis and mortality risk ofacute pancreatitis.They were introduced in 1974 by theEnglish-Americanpancreaticexpert andsurgeonDr. John Ranson (1938–1995).

Usage

A score of 3 or more indicates severe acute pancreatitis. This can causeorgan failure,necrosis,infected necrosis,pseudocyst,andabscess.If diagnosed with severe acute pancreatitis, people will need to be admitted to ahigh-dependency unitorintensive care unit.

Acute pancreatitis not secondary to gallstones

At admission:

1. Blood glucose> 11.11 mmol/L (> 200 mg/dL)
2. Age > 55 years
3. SerumLDH> 350 IU/L
4. SerumAST> 250 IU/L
5. WBCcount > 16000 cells/mm³

Within 48 hours:

1. Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
2. Hematocritdecreased by > 10%
3. Oxygen (hypoxemiawith PaO₂< 60 mmHg)
4. BUNincreased by 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
5. Base deficit (negativebase excess) > 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 > 6L

Alternatives

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

• APACHE IIscore ≥ 8
• Balthazar computed tomography severity index (CTSI)
• BISAP score
• Organ failure
• Substantial pancreatic necrosis (at least 30% glandular necrosis according to contrast-enhancedCT)
• Modified Glasgow Criteria

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