Ranson's Criteria
Estimates severity and mortality of acute pancreatitis.
Threshold values adapt automatically based on the chosen origin.
Ranson's Criteria: Evaluation of Acute Pancreatitis
Ranson's Criteria were introduced in 1974 by Dr. John H. Ranson. It is one of the earliest and most famous clinical scoring systems used to evaluate severity and predict mortality in acute pancreatitis. Although newer scores are often used today, the Ranson score remains a classic in gastroenterology and intensive care.
Difference between biliary and non-biliary pancreatitis
The precision of Ranson's criteria relies on distinguishing the etiology (cause) of the pancreatitis:
- Non-biliary (e.g., alcoholic, hypertriglyceridemia, idiopathic): The classic 11-point score is used (5 criteria at admission, 6 at 48 hours).
- Biliary (Gallstone): Severity thresholds are modified (e.g., age changes from >55 to >70 years). Furthermore, the pO2 criterion is removed, bringing the maximum score down to 10 points.
Major Limitation of the Score
The main limitation of the Ranson score is that it requires 48 hours to be fully calculated (assessing fluid losses, hematocrit drop, etc.). Therefore, it does not allow for immediate severity stratification within the first hour in the emergency department, unlike newer scores (such as BISAP).
Interpretation and Estimated Mortality
| Total Score | Severity | Estimated Mortality |
|---|---|---|
| 0 - 2 pts | Mild pancreatitis | 0 - 3 % |
| 3 - 4 pts | Moderate to severe pancreatitis | 15 % |
| 5 - 6 pts | Severe pancreatitis | 40 % |
| ≥ 7 pts | Fulminant pancreatitis | près de 100 % |
Scientific References:
1. Ranson JH, 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.
[PubMed]
2. Ranson JH. Etiological and prognostic factors in human acute pancreatitis: a review. Am J Gastroenterol. 1982;77(8):633-8.
[PubMed]
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