What are the Ranson criteria for staging acute pancreatitis?

Updated: Jul 24, 2019
  • Author: Jeffrey C F Tang, MD; Chief Editor: BS Anand, MD  more...
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Answer

Ranson used a series of different criteria for the severity of acute pancreatitis to formulate a scoring system that is still widely used. [28]

Criteria present on admission include the following:

  • Patient older than 55 years

  • WBC count higher than 16,000/µL

  • Blood glucose level higher than 200 mg/dL

  • Serum LDH level higher than 350 IU/L

  • AST level higher than 250 IU/L

Criteria developing during the first 48 hours include the following:

  • Hematocrit fall of more than 10%

  • BUN level increase by more than 8 mg/dL

  • Serum calcium level lower than 8 mg/dL

  • Pa O2 less than 60 mm Hg

  • Base deficit higher than 4 mEq/L

  • Estimated fluid sequestration higher than 6 L

Each of the above criteria counts for 1 point toward the score. A Ranson score of 0-2 has a minimal mortality, and the patient is admitted to the regular ward for medical therapy and support. A Ranson score of 3-5 has a 10%-20% mortality rate, and the patient should be admitted to the intensive care unit (ICU). A Ranson score higher than 5 after 48 hours has a mortality of more than 50% and is associated with more systemic complications.


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