This Ranson criteria for pancreatitis calculator uses the mortality risk clinical prediction rule at admission and within 24h for the severity of acute pancreatitis. Read more about this score below the form.
How does this Ranson criteria for pancreatitis calculator work?
This health tool assesses the mortality risk in the case of patients with acute pancreatitis based on clinical and lab values at the time of hospital admission and within 48 hours.
This Ranson criteria for pancreatitis calculator uses factors from the accurate model introduced in 1974 and estimates adverse outcome in pancreatitis.
The factors taken into account at admission are:
■ Age – patients aged 55 or over are consider to have a higher risk of adverse outcome in PA;
■ White blood cell count – patients usually present fever and high WBC as sign of inflammation;
■ Blood glucose levels – high levels due to impaired pancreas function;
■ Serum aspartate aminotransferase – increased AST levels are part of the diagnos is criteria of several abdominal conditions, including pancreas inflammation;
■ Serum lactate dehydrogenase – LDH to AST ratio is increased in gallbladder pancreatitis.
Criteria analyzed 24h into admission:
■ Hematocrit fall – hemoconcentration might suggest pancreas necrosis
■ Arterial oxygen pressure – PaO2 is a determination often met in scoring systems
■ Blood urea nitrogen – is recognized as an early marker of PA assessment
■ Serum calcium – Measurement of serum ionized calcium is necessary
■ Base deficit – Arterial pH, bicarbonate levels and base deficit at presentation are predictors of PA mortality risk
■ Sequestration of fluid – can result in hemodynamic impairment, hypovolemia, and in turn hypotension and reduced venous return to the heart.
The following table compares the Ranson criteria for non gallstone and gallstone pancreatitis:
| Criteria | Non gallstone pancreatitis | Gallstone pancreatitis |
| At admission | ||
| Age | > 55 | >70 |
| WBC | > 16,000 | > 18,000 |
| Glucose | > 200 mg/dL | > 220 mg/dL |
| Serum AST | > 250 | > 250 |
| Serum LDH | > 350 | > 400 |
| Within 48 hours | ||
| Hematocrit fall | > 10% | > 10% |
| Oxygen | < 60 mmHg | < 60 mmHg |
| BUN increase | > 5 mg/dL | > 2 mg/dL |
| Calcium | < 8 mg/dL | < 8 mg/dL |
| Base deficit | > 4 mEq/L | > 5 mEq/L |
| Fluid sequestration | > 6 L | > 4 L |
Ranson score interpretation
Within the model, each positive occurrence of the criteria involved is awarded a point and then the sum of the points defines the acute pancreatitis mortality risk.
| Points | Predicted mortality |
| 0 | 1% |
| 1, 2 | 2% |
| 3, 4 | 15% |
| 5, 6 | 40% |
| 7 - 11 | 100% |
Pancreatitis medical implications
This is the inflammation of the pancreas and is classified as acute in cases in which there isn’t any CT or endoscopic proof of a chronic pancreatic condition.
The most common forms are alcoholic and gallstone pancreatitis. Acute necrotizing pancreatitis is the severe inflammation with areas of necrosis of different stages and leads to diabetes mellitus and impaired absorbtion.
It is a condition more common in middle aged and elderly persons and men are more likely to develop the alcohol related one while women, the one as a result of gallstones.
Diagnosis follows criteria such as the characteristic abdominal pain, clinical determinations of serum amylase or lipase higher than normal, CT scan findings.
The management of acute episodes usually leads to recovery once the functions of the body have been reestablished and inflammation overcome, but when complications occur, this is a condition which can lead to multiple organ failure and prove fatal.
References
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. Surg Gynecol Obstet;139(1):69-81
2) Papachristou GI, Muddana V, Yadav D, O'Connell M, Sanders MK, Slivka A, Whitcomb DC. (2010) Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol; 105(2):435-41
22 Jul, 2015