Ranson's Criteria for Pancreatitis Mortality
Ranson's Criteria Calculator
Assess mortality risk in acute pancreatitis
Admission Criteria Present:
0 / 5
Total Ranson's Score:
0 / 11Mortality Risk:
< 1%
Severity Classification:
Mild Pancreatitis
Clinical Recommendation
Low risk. Consider standard ward management with appropriate monitoring.
What are Ranson's Criteria?
Ranson's criteria is a clinical prediction tool used to assess the severity and mortality risk of acute pancreatitis. Developed by John Ranson in 1974, it consists of 11 parameters measured at admission and at 48 hours after admission.
While newer scoring systems like APACHE II, BISAP, and the revised Atlanta classification are now available, Ranson's criteria remain widely used due to their simplicity and historical significance.
Clinical Parameters
| At Admission | |
|---|---|
| Age | > 55 years |
| White blood cell count | > 16,000/mm³ |
| Blood glucose | > 200 mg/dL (11.1 mmol/L) |
| Serum LDH | > 350 IU/L |
| Serum AST (SGOT) | > 250 IU/L |
| At 48 Hours | |
| Hematocrit decrease | > 10% |
| BUN increase | > 5 mg/dL (1.8 mmol/L) |
| Serum calcium | < 8 mg/dL (2 mmol/L) |
| Arterial PO₂ | < 60 mmHg (8 kPa) |
| Base deficit | > 4 mEq/L |
| Fluid sequestration | > 6 L |
Interpretation
The number of criteria present correlates with mortality risk:
| Criteria Present | Mortality Risk |
|---|---|
| 0-2 | < 1% |
| 3-4 | ~15% |
| 5-6 | ~40% |
| 7-8 | ~100% |
Clinical Applications
Ranson's criteria are used to:
- Predict the severity and mortality risk in acute pancreatitis
- Guide clinical decision-making regarding level of care (e.g., ICU admission)
- Identify patients who may benefit from early aggressive interventions
- Provide prognostic information for patients and families
Limitations
Despite its widespread use, Ranson's criteria have several limitations:
- Complete assessment requires 48 hours, delaying full risk stratification
- Some parameters may not be routinely measured (e.g., base deficit, fluid sequestration)
- Does not account for ongoing changes in clinical status beyond 48 hours
- Developed before modern intensive care and interventional techniques
- May be less accurate than newer scoring systems like APACHE II or BISAP
References
- Ranson JH, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81.
- Banks PA, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111.
- Papachristou GI, et al. Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105(2):435-441.