Ranson’s criteria explained

Introduction

The Ranson’s criteria for Acute Pancreatitis is a prognostic indicator for assessing the severity and mortality of Acute Pancreatitis. It is measured at the time of admission and 48 hours after admission. A higher score indicates a higher level of severity of acute pancreatitis with a corresponding increase in mortality.

Interpreting Ranson’s Criteria

1. Score 0 to 2 points = Mortality 0 to 3%
2. Score 3 to 5 points = Mortality 11 to 15%
3. Mortality 6 to 11 points = Mortality ≥ 40%

Ranson’s Criteria in-depth

Criteria present at 0 hours:

1. Age >55 years old (1 point)
2. WBC >16,000/microL (1 point)
3. Glucose >200 mg/dL [>11.1 mmol/L] (1 point)
4. LDH >350 international units/L [>5.83 microkat/L] (1 point)
5. AST >250 international units/L [>4.17 microkat/L] (1 point)

Criteria present at 48 hours:

1. Hematocrit fall of 10% or greater (1 point)
2. BUN rise of 5 mg/dL [1.8 mmol/L] or more despite fluids (1 point)
3. Serum calcium <8 mg/dL [<2 mmol/L] (1 point)
4. pO2 <60 mmHg [<8 kPa] (1 point)
5. Base deficit >4 mEq/L [>4 mmol/L] (1 point)
6. Fluid sequestration >6000 mL (1 point)

Fluid Sequestration (measured over a period of (48Hours) = Amount of fluid prescribed (via IV) - Fluid Output (Measured by urine amount)

Ranson’s Criteria Calculators

1. https://www.mdcalc.com/calc/89/ransons-criteria-pancreatitis-mortality#when-to-use
2. https://sniv3r2.github.io/d/topic.htm?path=calculator-ranson-criteria-for-pancreatitis-prognosis