The Ranson criteria form a clinical prediction rule for predicting the severity of acute pancreatitis. They were introduced in 1974 by the English-American Pancreatic Expert and Surgeon, Dr. John Ranson (1938–1995).
Contents
Usage
For non-gallstone pancreatitis, the parameters are:
At admission:
- Age in years > 55 years
- WBC count > 16000 cells/mm3
- Blood glucose > 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
The criterion for point assignment is that a certain breakpoint be met at any time during that 48-hour period, so that in some situations it can be calculated shortly after admission. It is applicable to non-gallstone 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.
For gallstone pancreatitis, the parameters are:
At admission:
- Age in years > 70 years
- White blood cell count > 18000 cells/mm3
- Blood glucose > 12.2 mmol/L (> 220 mg/dL)
- Serum AST > 250 IU/L
- Serum LDH > 400 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 0.7 or more mmol/L (2 or more mg/dL) after IV fluid hydration
- Base deficit (negative base excess) > 5 mEq/L
- Sequestration of fluids > 4 L
Alternatives
Alternatively, pancreatitis severity can be assessed by any of the following:
Interpretation
Or