www.MedicalCRITERIA.com

Home A-Z Index About Us Books Español
Sponsored Links

Sponsored Links

Severity Criteria for Acute Pancreatitis

Ranson Criteria to Predict Severity of Acute Pancreatitis

 

1. When three or more of the following are present on admission, a severe course complicated by pancreatic necrosis can be predicted with a sensitivity of 60-80%:

  • Age over 55 years.

  • White blood cell count over 16,000/uL.

  • Blood glucose over 200 mg/dL.

  • Serum lactate dehydrogenase (LDH) over 350 units/L.

  • Aspartate aminotransferase (AST, SGOT) over 250 units/L.

2. Development of the following in the first 48 hours indicates a worsening prognosis:

  • Hematocrit drop of more than ten percentage points.

  • Blood urea nitrogen (BUN) rise greater than 5 mg/dL.

  • Arterial PO2 of less than 60 mm Hg.

  • Serum calcium of less than 8 mg/dL.

  • Base deficit over 4 meq/L.

  • Estimated fluid sequestration of more than 6 L.

3. Mortality rates correlate with the number of criteria present:

 

Number of criteria    

Mortality rate

0-2

1%

3-4

16%

5-6

40%

7-8

100%

  

 

Balthazar CT severity index for acute pancreatitis.

 

CT Grade

Points

Necrosis

(%)

Additional

Points

Severity

Index

Mortality

Rate (%)

A Normal pancreas

0

0

0

0

0

B Pancreatic enlargement

1

0

0

1

0

C Pancreatic inflammation and/or peripancreatic fat

2

< 30

2

4

0

D Single peripancreatic fluid collection

3

30-50

4

7

> 17

E Two or more fluid collections or retroperitoneal air

4

> 50

6

10

 

 

Related Criteria

Diagnostic Criteria for Autoimmune Pancreatitis

Diagnostic Criteria for Zollinger-Ellison Syndrome (ZES)

Diagnostic Criteria for Autoimmune Hepatitis (AIH)

Child-Pugh Classification of Severity of Liver Disease

Diagnostic Criteria for Wilson's disease

More...

 

References:

  1. Ranson JH. Acute pancreatitis: pathogenesis, outcome and treatment. Clin Gastroenterol. 1984 Sep;13(3):843-63. [Medline]

  2. Balthazar EJ: Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology 2002;223:603. [Medline]

Sponsored Links

 

Created: January 07, 2006
Last Modified: 10/17/2010

 
MedicalCRITERIA.com 2006 all rights reserved.                                                                     Contact Us.