Ranson criteria

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The Ranson criteria form a clinical prediction rule for predicting the severity of acute pancreatitis. They were introduced in 1974.[1]

Usage[edit]

For non-gallstone pancreatitis, the parameters are:

At admission:

  1. Age in years > 55 years
  2. White blood cell count > 16000 cells/mm3
  3. Blood glucose > 10 mmol/L (> 200 mg/dL)
  4. Serum AST > 250 IU/L
  5. Serum LDH > 350 IU/L

Within 48 hours:

  1. Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
  2. Hematocrit fall > 10%
  3. Oxygen (hypoxemia 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

The criterion for point assignment is that a certain breakpoint be met at anytime during that 48 hour period, so that in some situations it can be calculated shortly after admission. It is applicable to non-gallstone pancreatitis.


For gallstone pancreatitis, the parameters are:[2]

At admission:

  1. Age in years > 70 years
  2. White blood cell count > 18000 cells/mm3
  3. Blood glucose > 12.2 mmol/L (> 220 mg/dL)
  4. Serum AST > 250 IU/L
  5. Serum LDH > 400 IU/L

Within 48 hours:

  1. Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
  2. Hematocrit fall > 10%
  3. Oxygen (hypoxemia PaO2 < 60 mmHg)
  4. BUN increased by 0.7 or more mmol/L (2 or more mg/dL) after IV fluid hydration
  5. Base deficit (negative base excess) > 5 mEq/L
  6. Sequestration of fluids > 4 L

Alternatives[edit]

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

  • APACHE II score ≥ 8
  • Organ failure
  • Substantial pancreatic necrosis (at least 30% glandular necrosis according to contrast-enhanced CT)

Interpretation[edit]

Or

References[edit]

  1. ^ 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. 
  2. ^ http://bestpractice.bmj.com/best-practice/monograph/66/diagnosis/criteria.html
  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. Retrieved 2009-02-08.