Ranson Criteria (acute pancreatitis severity)
Acute pancreatitis severity scored at admission and 48 hours later. A score ≥ 3 indicates moderate-to-severe disease.
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 Now superseded by APACHE II (more sensitive and applicable across diseases), BISAP (simplified, 5 criteria in the first 24 hours), and the revised Atlanta classification 2012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 Uses outdated thresholds – the glucose 11.1 mmol/L threshold is already exceeded by many T2DM patients, falsely raising the score.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