Hepatology & GastroenterologyEvidence-Based Golden Standard
Ranson's Criteria — Acute Pancreatitis Severity
Predicts severity and mortality in acute (non-gallstone) pancreatitis. Phase-1 criteria are scored at admission; Phase-2 criteria at 48 hours. Each is 1 point.
At admission: Age >55 · WBC >16 ×10⁹/L · Glucose >200 mg/dL (>11 mmol/L) · LDH >350 IU/L · AST >250 IU/L
At 48 h: Hct fall >10% · BUN rise >5 mg/dL · Ca <8 mg/dL · PaO₂ <60 mmHg · Base deficit >4 mEq/L · Fluid sequestration >6 L
Total 0–11. 0–2 mortality ~1% · 3–4 ~15% · 5–6 ~40% · ≥7 ~100%
Published Clinical Benchmark Cases
Clinical Parameters & Inputs
Computed OutputMild Pancreatitis (Score 0)
0points
Diagnostic Interpretation
Ranson's score is 0 (~0–2% mortality). Mild, interstitial pancreatitis — supportive care with aggressive IV fluids, analgesia, and early enteral feeding when tolerated.
Calculation Breakdown
Admission Criteria (0–5)
Age, WBC, glucose, LDH, AST =0 point(s)
48-hour Criteria (0–6)
Hct, BUN, Ca, PaO₂, base deficit, fluid =0 point(s)
Total
0 + 0 =0 / 11 (mortality ~0–2%)
Clinical Decision Pearls
- Aggressive early isotonic fluid resuscitation (goal-directed) is the single most important intervention in the first 24 hours.
- Gallstone pancreatitis has a separate modified Ranson score; identify and treat the cause (early ERCP for cholangitis).
Limitations & Confounders
- Ranson requires 48 hours to complete — it cannot stratify risk on presentation; use it alongside early markers (BUN, hematocrit, CRP).
- The original criteria were derived before modern critical care and imaging; contemporary practice favors SIRS, BISAP, and the revised Atlanta classification.
Evidence & Citations
- Ranson JHC, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81.