Ranson's Criteria (Acute Pancreatitis)

Predicts severity and mortality in acute pancreatitis at admission and 48 hours.

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Parameters

Admission: Age > 55 years

Yes, this condition applies to the patient

Admission: WBC > 16,000 /µL (16 × 10⁹/L)

Yes, this condition applies to the patient

Admission: Blood Glucose > 200 mg/dL (11.1 mmol/L)

Yes, this condition applies to the patient

Admission: Serum LDH > 350 IU/L

Yes, this condition applies to the patient

Admission: AST (SGOT) > 250 IU/L

Yes, this condition applies to the patient

At 48 Hours: Hematocrit drop > 10 percentage points

Yes, this condition applies to the patient

At 48 Hours: BUN rise > 5 mg/dL (1.8 mmol/L) despite IV fluids

Yes, this condition applies to the patient

At 48 Hours: Serum Calcium < 8.0 mg/dL (2.0 mmol/L)

Yes, this condition applies to the patient

At 48 Hours: Arterial PaO₂ < 60 mmHg (on room air)

Yes, this condition applies to the patient

At 48 Hours: Base Deficit > 4 mEq/L

Yes, this condition applies to the patient

At 48 Hours: Estimated fluid sequestration > 6 Liters

Yes, this condition applies to the patient

Ranson's Criteria (Acute Pancreatitis) Result

Formula

Sum of 11 criteria: Admission [Age>55, WBC>16k, Glucose>200, LDH>350, AST>250] + 48h [Hct drop>10%, BUN rise>5, Ca<8, PaO2<60, Base Deficit>4, Fluid loss>6L]

Clinical Pearls

One of the most classic bedside prognostic tools used to triage patients with acute pancreatitis into appropriate floor vs. intensive care settings.

Limitations

Requires a full 48 hours of hospitalization to complete the score; newer tools (e.g. BISAP, APACHE II) can be completed more rapidly upon presentation.

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