Ranson Criteria (acute pancreatitis severity)
Acute pancreatitis severity scored at admission and 48 hours later. A score ≥ 3 indicates moderate-to-severe disease.
Updated · Methodology
About this calculator
Ranson criteria predict acute pancreatitis severity and mortality. Developed by Ranson et al. (Surg Gynecol Obstet, 1974) in 100 patients. Eleven parameters scored at two timepoints: 5 on admission and 6 at 48 hours. Each criterion 1 point. On admission. Age >55 (>70 for biliary pancreatitis), WBC >16×10⁹/L, glucose >11.1 mmol/L, LDH >350 U/L, AST >250 U/L. At 48 hours. Hematocrit drop >10%, BUN rise >1.8 mmol/L, calcium <2 mmol/L, PaO2 <60 mm Hg, base deficit >4 mmol/L, fluid sequestration >6 L. Interpretation. 0-2 – mortality <1%, mild pancreatitis, ward care. 3-4 – mortality 15%, moderate-severe, intermediate care. 5-6 – 40%, severe, ICU. >=7 – 100%, very severe. Clinical use. Before 2012 – primary pancreatitis severity score. Now superseded by APACHE II (more sensitive and applicable across diseases), BISAP (simplified, 5 criteria in the first 24 hours), and the revised Atlanta classification 2012 (organ failure and local complications). Current international guidance IAP/APA 2013 and ACG 2024 recommend BISAP over Ranson. Limitations. Requires 48 hours of observation for full scoring – not used for early decisions. Does not incorporate CT findings (necrosis, sequestration). Uses outdated thresholds – the glucose 11.1 mmol/L threshold is already exceeded by many T2DM patients, falsely raising the score. Calcium without albumin correction is inaccurate. Today Ranson is mainly historical; clinically BISAP and Atlanta are preferred.
Source
Formula version: ranson-1974-banks-2013-v1