Ranson Criteria (Pancreatitis)
Predicts severity of acute pancreatitis. Criteria assessed at admission and at 48 hours.
How to use & interpret
Ranson's criteria estimate the severity and mortality of acute pancreatitis using parameters at admission and again at 48 hours. A higher number of criteria correlates with higher mortality; broadly, ≥3 indicates severe pancreatitis.
Because it needs 48 hours to complete, it cannot guide the earliest decisions, and modern practice often favours APACHE II, the Glasgow-Imrie score, or simple markers (CRP, the SIRS response). Use it as one input alongside clinical trajectory and imaging.
Score interpretation
Score 0–2: Mild pancreatitis. Mortality < 1%.
→ IV fluids, analgesia, NBM, monitoring. Most will settle with conservative management.
Score 3–4: Moderate severity. Mortality ~15%.
→ HDU admission. Aggressive fluid resuscitation. Early ERCP if biliary. Specialist GI review.
Score ≥5: Severe pancreatitis. Mortality ~40–100%.
→ ICU admission. Aggressive resuscitation. CT pancreas to assess necrosis. Early surgical/IR involvement. Consider broad-spectrum antibiotics if infected necrosis.
Interpretation bands for the Ranson. Apply clinical judgement and local guidance.
Frequently asked questions
Ranson, Glasgow-Imrie or APACHE II?
Glasgow-Imrie is simpler and UK-favoured at 48 hours; APACHE II can be calculated early and serially; Ranson is historically important but needs 48 hours. Many units combine a severity score with CRP and clinical assessment.
References
- Ranson JH et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974.
Related
Curated clinical cross-links plus same-class fallbacks.
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.