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Ranson’s criteria

Adds 5 admission and 6 first-48-hour criteria to estimate acute pancreatitis severity and mortality; biliary pancreatitis has separate cutoffs.

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Method · Limits of application

Ranson 1974 nonbiliary and Ranson 1982 biliary; admission+48 h; aetiology-specific thresholds

Ranson criteria combine admission data with 48-hour data; criteria and thresholds differ between biliary and nonbiliary pancreatitis. Do not treat items not yet observed as absent or a partial total as the complete assessment. The 2024 ACG guideline notes that systems such as Ranson do not accurately predict severe progression in the first 24–48 hours and do not replace reassessment of organ failure and clinical signs. Follow-up and initial support should not wait for the score to be complete.

Required fields: 0/11 completed

Complete all required fields. Optional fields are marked.

Admission: age > 55 years (biliary: > 70) required

Admission: leukocytes > 16,000/mm³ (biliary: > 18,000) required

Admission: blood glucose > 200 mg/dL (biliary: > 220) required

Admission: LDH > 350 U/L (biliary: > 400) required

Admission: AST > 250 U/L required

48 h: hematocrit fall > 10 percentage points required

48 h: BUN increase > 5 mg/dL, urea > 10.7 mg/dL (biliary: BUN > 2, urea > 4.3) required

48 h: calcium < 8 mg/dL required

48 h: PaO₂ < 60 mmHg (not applicable to biliary disease) required

48 h: base deficit > 4 mEq/L (biliary: > 5) required

48 h: fluid sequestration > 6 L (biliary: > 4 L) required

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Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Admission: age > 55 years (biliary: > 70)
Admission: leukocytes > 16,000/mm³ (biliary: > 18,000)
Admission: blood glucose > 200 mg/dL (biliary: > 220)
Admission: LDH > 350 U/L (biliary: > 400)
Admission: AST > 250 U/L
48 h: hematocrit fall > 10 percentage points
48 h: BUN increase > 5 mg/dL, urea > 10.7 mg/dL (biliary: BUN > 2, urea > 4.3)
48 h: calcium < 8 mg/dL
48 h: PaO₂ < 60 mmHg (not applicable to biliary disease)
48 h: base deficit > 4 mEq/L (biliary: > 5)
48 h: fluid sequestration > 6 L (biliary: > 4 L)

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

One point per criterion: 5 at admission and 6 in the first 48 hours. Total 0–11 (0–10 in biliary pancreatitis, which omits PaO₂).

Values in parentheses are biliary pancreatitis cutoffs (Ranson 1982).

References

Identifier: criterios-de-ranson

Original clinical content: Brazilian Portuguese.

Method version

Ranson 1974 nonbiliary and Ranson 1982 biliary; admission+48 h; aetiology-specific thresholds

criterios-de-ranson@native-2026-10-03+0c99e193a5f1

Ranson JH et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet, 1974. (PubMed)

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Admission: age > 55 years (biliary: > 70): Yes
Admission: leukocytes > 16,000/mm³ (biliary: > 18,000): Yes
Admission: blood glucose > 200 mg/dL (biliary: > 220): No
Admission: LDH > 350 U/L (biliary: > 400): No
Admission: AST > 250 U/L: No
48 h: hematocrit fall > 10 percentage points: No
48 h: BUN increase > 5 mg/dL, urea > 10.7 mg/dL (biliary: BUN > 2, urea > 4.3): No
48 h: calcium < 8 mg/dL: No
48 h: PaO₂ < 60 mmHg (not applicable to biliary disease): No
48 h: base deficit > 4 mEq/L (biliary: > 5): No
48 h: fluid sequestration > 6 L (biliary: > 4 L): No

{
  "idade": true,
  "leuco": true,
  "glic": false,
  "ldh": false,
  "ast": false,
  "ht": false,
  "bun": false,
  "ca": false,
  "pao2": false,
  "be": false,
  "seq": false
}

Expected result

{
  "score": 2,
  "level": "low"
}

Actual result

{
  "score": 2
}

Case 2

reference-002

Inputs

Admission: age > 55 years (biliary: > 70): Yes
Admission: LDH > 350 U/L (biliary: > 400): Yes
48 h: calcium < 8 mg/dL: Yes
48 h: fluid sequestration > 6 L (biliary: > 4 L): Yes
Admission: leukocytes > 16,000/mm³ (biliary: > 18,000): No
Admission: blood glucose > 200 mg/dL (biliary: > 220): No
Admission: AST > 250 U/L: No
48 h: hematocrit fall > 10 percentage points: No
48 h: BUN increase > 5 mg/dL, urea > 10.7 mg/dL (biliary: BUN > 2, urea > 4.3): No
48 h: PaO₂ < 60 mmHg (not applicable to biliary disease): No
48 h: base deficit > 4 mEq/L (biliary: > 5): No

{
  "idade": true,
  "ldh": true,
  "ca": true,
  "seq": true,
  "leuco": false,
  "glic": false,
  "ast": false,
  "ht": false,
  "bun": false,
  "pao2": false,
  "be": false
}

Expected result

{
  "score": 4,
  "level": "mid"
}

Actual result

{
  "score": 4
}

Case 3

reference-003

Inputs

Admission: age > 55 years (biliary: > 70): Yes
Admission: leukocytes > 16,000/mm³ (biliary: > 18,000): Yes
Admission: blood glucose > 200 mg/dL (biliary: > 220): Yes
Admission: LDH > 350 U/L (biliary: > 400): Yes
48 h: hematocrit fall > 10 percentage points: Yes
48 h: calcium < 8 mg/dL: Yes
48 h: PaO₂ < 60 mmHg (not applicable to biliary disease): Yes
Admission: AST > 250 U/L: No
48 h: BUN increase > 5 mg/dL, urea > 10.7 mg/dL (biliary: BUN > 2, urea > 4.3): No
48 h: base deficit > 4 mEq/L (biliary: > 5): No
48 h: fluid sequestration > 6 L (biliary: > 4 L): No

{
  "idade": true,
  "leuco": true,
  "glic": true,
  "ldh": true,
  "ht": true,
  "ca": true,
  "pao2": true,
  "ast": false,
  "bun": false,
  "be": false,
  "seq": false
}

Expected result

{
  "score": 7,
  "level": "high",
  "verdict": "muito grave"
}

Actual result

{
  "score": 7
}

Code and reproducibility

This tool’s code on GitHub

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Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.