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Ranson Criteria for Pancreatitis

Estimates acute pancreatitis severity using admission and 48 hour criteria.

When to use

Acute pancreatitis in adults after completing admission and 48 hour criteria.

Pearls and pitfalls
  • Five criteria are assessed at admission and six during the first 48 hours.
  • Three or more criteria are associated with severe pancreatitis and higher mortality.
  • The score should not be calculated before 48 hours are complete for the late criteria.
  • Use with imaging, volume response and current scores for critical care decisions.

Age above 55 years

White cells above 16,000/µL

Glucose above 200 mg/dL

LDH above 350 U/L

AST above 250 U/L

Hematocrit drop greater than 10% at 48 hours

Blood urea nitrogen (BUN) rise greater than 5 mg/dL at 48 hours

Calcium below 8 mg/dL

PaO2 below 60 mmHg

Base deficit greater than 4 mmol/L

Fluid sequestration greater than 6 L

0/11 criteria

Low to moderate severity

Keep hydration, analgesia and serial clinical reassessment.

Formula

Add 1 point per criterion present at admission and at 48 hours, up to 11 points.

Evidence

Criteria derived to estimate severity and mortality in acute pancreatitis, with cutoffs of 3 and 5.

References

  1. Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81. https://pubmed.ncbi.nlm.nih.gov/4834279/

Frequently asked questions

What is Ranson Criteria for Pancreatitis?

Estimates acute pancreatitis severity using admission and 48 hour criteria. Acute pancreatitis in adults after completing admission and 48 hour criteria.

How is the result calculated?

Add 1 point per criterion present at admission and at 48 hours, up to 11 points.

How should the result be interpreted?

Criteria derived to estimate severity and mortality in acute pancreatitis, with cutoffs of 3 and 5.

What are the sources?

Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81.

Updated