Ranson Criteria Calculator for Pancreatitis
Estimate the severity and mortality risk of acute pancreatitis with Ranson’s criteria. Five findings are checked at admission and six more at 48 hours, each scoring one point, for a total of 0 to 11. A score of 3 or more indicates severe pancreatitis. Tick the criteria that are met — the 48-hour items need repeat bloods.
About Ranson’s criteria
Ranson’s criteria predict the severity and mortality of acute pancreatitis from five findings at admission and six at 48 hours. Source: Ranson JH et al., “Prognostic signs and the role of operative management in acute pancreatitis,” Surg Gynecol Obstet 1974;139(1):69–81. Compare with the earlier BISAP score.
How this is calculated
| Factor | Points |
|---|---|
| Admission: age > 55 | 1 |
| Admission: WBC > 16,000/µL | 1 |
| Admission: glucose > 200 mg/dL | 1 |
| Admission: AST > 250 IU/L | 1 |
| Admission: LDH > 350 IU/L | 1 |
| 48 h: calcium < 8 mg/dL | 1 |
| 48 h: haematocrit fall > 10% | 1 |
| 48 h: PaO₂ < 60 mmHg | 1 |
| 48 h: BUN rise > 5 mg/dL | 1 |
| 48 h: base deficit > 4 mEq/L | 1 |
| 48 h: fluid sequestration > 6 L | 1 |
| Maximum | 11 |
Add one point for each criterion met. Score ≥ 3 = severe. Approximate mortality: 2% (0–2), 15% (3–4), 40% (5–6), ≈ 100% (7+). Classic non-gallstone criteria. Source: Ranson JH et al., Surg Gynecol Obstet 1974;139(1):69–81.
Frequently asked questions
What are Ranson’s criteria at admission?
The five admission criteria (non-gallstone pancreatitis) each score one point: age over 55 years; white-cell count over 16,000 cells/µL; blood glucose over 200 mg/dL (11.1 mmol/L); serum AST over 250 IU/L; and serum LDH over 350 IU/L. These are the values available when the patient first presents. All five come from a single admission blood draw and vital signs, reflecting the inflammatory and metabolic derangement already present before the disease has had time to declare its full severity.
What are the criteria at 48 hours?
Six further criteria are assessed at 48 hours, each one point: serum calcium under 8 mg/dL; a fall in haematocrit of more than 10%; arterial oxygen (PaO₂) under 60 mmHg; a rise in blood urea nitrogen (BUN) of more than 5 mg/dL after fluids; a base deficit over 4 mEq/L; and fluid sequestration over 6 litres. They capture the deterioration that marks severe disease, which is why the full score cannot be completed until 48 hours have passed. Because they need a second round of blood tests and a running fluid-balance calculation, these items must be tracked prospectively from admission rather than calculated retrospectively from a single set of labs.
What mortality does the Ranson score predict?
In the original work mortality rose sharply with the score: about 2% at 0–2, 15% at 3–4, 40% at 5–6 and approaching 100% at 7 or more. A score of 3 or more defines severe acute pancreatitis. The figures are approximate and derived from older cohorts, so use the band rather than an exact percentage.
What is the main limitation of Ranson’s criteria?
The full score needs 48 hours of data, so it cannot risk-stratify a patient on arrival, and it is calculated only once rather than tracked. Simpler bedside tools such as BISAP give an earlier estimate. Ranson also has two slightly different versions — for gallstone and non-gallstone pancreatitis; this calculator uses the classic non-gallstone criteria.
When should it not be relied on?
Ranson’s criteria estimate severity and mortality risk in acute pancreatitis; they are not a diagnosis and do not dictate management, and a patient can be severely ill with a low score early on. Use with clinical judgement, imaging and the trend of the illness. This is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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