Ranson criteria

The Ranson criteria form a clinical prediction rule for predicting the prognosis and mortality risk of acute pancreatitis. They were introduced in 1974 by the English-American pancreatic expert and surgeon Dr. John Ranson (1938–1995).

Usage
A score of 3 or more indicates severe acute pancreatitis. This can cause organ failure, necrosis, infected necrosis, pseudocyst, and abscess. If diagnosed with severe acute pancreatitis, people will need to be admitted to a high-dependency unit or intensive care unit.

Acute pancreatitis not secondary to gallstones
At admission: Within 48 hours:
 * 1) Blood glucose > 11.11 mmol/L (> 200 mg/dL)
 * 2) Age > 55 years
 * 3) Serum LDH > 350 IU/L
 * 4) Serum AST > 250 IU/L
 * 5) WBC count > 16000 cells/mm3
 * 1) Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
 * 2) Hematocrit decreased by > 10%
 * 3) Oxygen (hypoxemia with PaO2 < 60 mmHg)
 * 4) BUN increased by 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
 * 5) Base deficit (negative base excess) > 4 mEq/L
 * 6) Sequestration of fluids > 6 L

Acute pancreatitis secondary to gallstones
At admission: Within 48 hours:
 * 1) Glucose > 220 mg/dl
 * 2) Age > 70 years
 * 3) LDH > 400 IU/L
 * 4) AST > 250 IU/ 100 ml
 * 5) WBC count > 18000 cells/mm3
 * 1) Serum calcium < 8 mg/dL
 * 2) Hematocrit decreased by > 10%
 * 3) Base deficit > 4 mEq/L
 * 4) BUN increased by > 2 mg/dL
 * 5) Sequestered fluid > 6L

Alternatives
Alternatively, pancreatitis severity can be assessed by any of the following:
 * APACHE II score ≥ 8
 * Balthazar computed tomography severity index (CTSI)
 * BISAP score
 * Organ failure
 * Substantial pancreatic necrosis (at least 30% glandular necrosis according to contrast-enhanced CT)
 * Modified Glasgow Criteria

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