Ranson's Criteria

Acute pancreatitis severity — 5 criteria at admission, 6 at 48 hours (non-gallstone cutoffs)
At admission
Age > 55 years
White cell count > 16 000/mm³
Blood glucose > 200 mg/dL (> 11.1 mmol/L)
AST > 250 IU/L
LDH > 350 IU/L
During the first 48 hours
Haematocrit fall > 10%
Blood urea nitrogen rise > 5 mg/dL despite fluids
Serum calcium < 8 mg/dL (< 2.0 mmol/L)
PaO₂ < 60 mmHg
Base deficit > 4 mEq/L
Estimated fluid sequestration > 6 L
Evidence
Original publication
Ranson JHC, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Identified 11 early objective signs (5 on admission, 6 at 48 h) that correlated with morbidity and mortality; mortality was ~1% with < 3 signs, ~15% with 3–4, ~40% with 5–6, and ~100% with ≥ 7.
Surgery, Gynecology & Obstetrics, 1974
Open source
Guideline
The full score needs 48 hours, so it cannot triage at presentation, and its discrimination is only moderate. Contemporary guidelines (ACG, IAP/APA) favour ongoing assessment of organ failure (e.g. SIRS, BISAP, the revised Atlanta classification) alongside or instead of Ranson. Use the non-gallstone cutoffs here; gallstone pancreatitis has a different criteria set.
Last reviewed: 2026-09
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