Ranson criteria

Ranson criteria is a clinical prediction rule for predicting the severity of acute pancreatitis. It was introduced in 1974.cite journal |author=Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC |title=Prognostic signs and the role of operative management in acute pancreatitis |journal=Surgery, gynecology & obstetrics |volume=139 |issue=1 |pages=69–81 |year=1974 |pmid=4834279 |doi=]

Usage

Parameters used:

At admission:
# age in years > 55 years
# white blood cell count > 16000 /mcL
# blood glucose > 11 mmol/L (> 200 mg/dL)
# serum AST > 250 IU/L
# serum LDH > 350 IU/L

After 48 hours:
# Calcium (serium calcium < 2.0 mmol/L (< 8.0 mg/dL)
# Haematocrit fall > 10%
# Oxygen (hypoxemia P_O2 < 60 mmHg)
# BUN increased by 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
# Base deficit > 4 Meq/L
# Sequestration of fluids > 6 L

The criteria for point assignment is that a certain breakpoint be met at anytime during that 48 hour period, so that in some situations it can be calculated shortly after admission. It is applicable to both biliary and alcoholic pancreatitis.

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

Mnemonic for memorizing Ranson's criteria

*At admission: "GA LAW" (Glucose, Age, LDH, AST, WBC count)
*At 48 hours: "C Hobbs" (ie. Calvin and Hobbs): (Calcium, Hematocrit, O2, BUN, Base deficit, Sequestration)

References