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).[1]
Usage
This is for causes other than gall stones.
At admission:
- Age in years > 55 years
- WBC count > 16000 cells/mm3
- Blood glucose > 11.11 mmol/L (> 200 mg/dL)
- Serum AST > 250 IU/L
- Serum LDH > 350 IU/L
Within 48 hours:
- Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
- Hematocrit fall > 10%
- Oxygen (hypoxemia 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
For acute pancreatitis secondary to gall stones.
At admission:
- Glucose > 220mg/dl
- Age > 70 years
- LDH > 400IU/L
- AST > 250IU/L
- WBCs > 18000/ mm3
Within 48 hours:
- S. Calcium < 8mg%
- Hematocrit >10%
- Base deficit > 4 mEq/L
- BUN > 2mg%
- Sequestrated fluid > 6L
Score of 3 or more indicates severe acute pancreatitis.
The mnemonic GALAW & CHOBBS can be used to remember this criteria. Stands for Glucose, Age, LDH, AST and WBC; Calcium, Hematocrit, Oxygen, BUN, Base, Sequestration.
Alternatives
Alternatively, pancreatitis severity can be assessed by any of the following:[2]
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
References
- Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC (1974). "Prognostic signs and the role of operative management in acute pancreatitis". Surgery, Gynecology & Obstetrics. 139 (1): 69–81. PMID 4834279.
- Baron, Todd H.; Desiree E. Morgan (1999-05-06). "Acute Necrotizing Pancreatitis". N Engl J Med. 340 (18): 1412–1417. doi:10.1056/NEJM199905063401807. PMID 10228193. Retrieved 2009-02-08.
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