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Ransons criteria for acute pancreatitis

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2016-01-22 01:18:42
Ransons criteria

Ranson's criteria are useful in assessing prognosis in early acute pancreatitis. The more of the criteria are met the higher the mortality. Ranson's criteria are assessed both at admission and at 48 hours.

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Mnemonic -
WALLS OF CHUB

At admission

W wbc >16000\\cu.mm
A age>55
L liver enzyme AST>250U/100ml
L LDH>350iu/L
S sugar blood glucose>200mg/dl


During 48 hours

O pao2<55mmHg
F fluid sequestration>6L
C calcium<8mg dl
H hct >10 percent fall from admission
U BUN elevation >5mg dl
B base deficit>4mEq/l


Calculated on admission, and at 48 hours, to estimate mortality from pancreatitis.
Helps determine the disposition of the patient, with a higher score corresponding to a higher level of care.

Ranson's Criteria was developed in the 1970s to address pancreatitis mortality; however, it may over-estimate mortality given its study and development 30-40 years ago. The BISAP Score requires fewer patient variables and is likely just as accurate -- if not moreso -- than Ranson's criteria for predicting adverse outcome in patients with acute pancreatitis.

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

   
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