- Source: 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 (1938–1995).
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:
Blood glucose > 11.11 mmol/L (> 200 mg/dL)
Age > 55 years
Serum LDH > 350 IU/L
Serum AST > 250 IU/L
WBC count > 16000 cells/mm3
Within 48 hours:
Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
Hematocrit decreased by > 10%
Oxygen (hypoxemia with PaO2 < 60 mmHg)
BUN increased by 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
Base deficit (negative base excess) > 4 mEq/L
Sequestration of fluids > 6 L
= Acute pancreatitis secondary to gallstones
=At admission:
Glucose > 220 mg/dl
Age > 70 years
LDH > 400 IU/L
AST > 250 IU/ 100 ml
WBC count > 18000 cells/mm3
Within 48 hours:
Serum calcium < 8 mg/dL
Hematocrit decreased by > 10%
Base deficit > 4 mEq/L
BUN increased by > 2 mg/dL
Sequestered fluid > 6L
Alternatives
Alternatively, pancreatitis severity can be assessed by any of the following:
APACHE II score ≥ 8
Balthazar computed tomography severity index (CTSI)
BISAP score
Organ failure
Substantial pancreatic necrosis (at least 30% glandular necrosis according to contrast-enhanced CT)
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