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Ranson criteria

From Wikipedia, the free encyclopedia
Medical diagnostic method
Ranson criteria
Purposeassess mortality risk of acute pancreatitis

TheRanson criteria form aclinical prediction rule for predicting the prognosis and mortality risk ofacute pancreatitis.[1] They were introduced in 1974 by theEnglish-Americanpancreatic expert andsurgeon Dr. John Ranson (1938–1995).[2]

Usage

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A score of 3 or more indicates severe acute pancreatitis. This can causeorgan failure,necrosis, infected necrosis,pseudocyst, andabscess. If diagnosed with severe acute pancreatitis, people will need to be admitted to ahigh-dependency unit orintensive care unit.

Acute pancreatitis not secondary to gallstones

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At admission:

  1. Blood glucose > 11.11 mmol/L (> 200 mg/dL)
  2. Age > 55 years
  3. SerumLDH > 350 IU/L
  4. SerumAST > 250 IU/L
  5. WBC count > 16000 cells/mm3

Within 48 hours:

  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 (negativebase excess) > 4 mEq/L
  6. Sequestration of fluids > 6 L

Acute pancreatitis secondary to gallstones

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At admission:

  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

Within 48 hours:

  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

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Alternatively, pancreatitis severity can be assessed by any of the following:[3]

  • 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-enhancedCT)
  • Modified Glasgow Criteria

Interpretation

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  • 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

References

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  1. ^Basit, Hajira; Ruan, Gordon J.; Mukherjee, Sandeep (2025),"Ranson Criteria",StatPearls, Treasure Island (FL): StatPearls Publishing,PMID 29493970, retrieved2025-03-18
  2. ^Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC (1974). "Prognostic signs and the role of operative management in acute pancreatitis".Surgery, Gynecology & Obstetrics.139 (1):69–81.PMID 4834279.
  3. ^Baron, Todd H.; Desiree E. Morgan (1999-05-06)."Acute Necrotizing Pancreatitis".N Engl J Med.340 (18):1412–1417.doi:10.1056/NEJM199905063401807.PMID 10228193. Retrieved2009-02-08.
Tests and procedures involving thehuman digestive system
Digestive tract
Upper GI tract
SGs /Esophagus
Stomach
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Lower GI tract
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Rectum
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Medical imaging
Stool tests
Accessory
Liver
Gallbladder,bile duct
Pancreas
Abdominopelvic
Peritoneum
Hernia
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Clinical prediction rules
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