Ranson criteria
The Ranson criteria form a clinical prediction rule for predicting the severity of acute pancreatitis. They were introduced in 1974.[1]
Usage
For non-gallstone pancreatitis, the parameters are:
At admission:
- Age in years > 55 years
- WBC count > 16000 cells/mm3
- Blood glucose > 11 mmol/L (> 200 mg/dL)
- Serum AST > 250 IU/L
- Serum LDH > 350 IU/L
Within 48 hours:
- Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
- Hematocrit fall > 10%
- Oxygen (hypoxemia PaO2 < 60 mmHg)
- BUN increased by 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
- Base deficit (negative base excess) > 4 mEq/L
- Sequestration of fluids > 6 L
The criterion for point assignment is that a certain breakpoint be met at any time during that 48-hour period, so that in some situations it can be calculated shortly after admission. It is applicable to non-gallstone pancreatitis.
The mnemonic GALAW AND CHOBBS can be used to remember this criteria. Stands for Glucose, Age, LDH, AST and WBC; Calcium, Hematocrit, Oxygen, BUN, Base, Sequestration.
For gallstone pancreatitis, the parameters are:[2]
At admission:
- Age in years > 70 years
- White blood cell count > 18000 cells/mm3
- Blood glucose > 12.2 mmol/L (> 220 mg/dL)
- Serum AST > 250 IU/L
- Serum LDH > 400 IU/L
Within 48 hours:
- Serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
- Hematocrit fall > 10%
- Oxygen (hypoxemia PaO2 < 60 mmHg)
- BUN increased by 0.7 or more mmol/L (2 or more mg/dL) after IV fluid hydration
- Base deficit (negative base excess) > 5 mEq/L
- Sequestration of fluids > 4 L
Alternatives
Alternatively, pancreatitis severity can be assessed by any of the following:[3]
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
References
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- ↑ http://bestpractice.bmj.com/best-practice/monograph/66/diagnosis/criteria.html
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