By Molly Lewis
For patients diagnosed with acute pancreatitis, the Ranson criteria can be used to predict which patients will have poor outcomes. The criteria look at a patient’s lab values, etc., when they are admitted and then again 48 hours later.
Each criterion gives the patient 1 point:
|score||risk of mortality|
|3-4||15%||if score ? 3, = severe disease
Whether or not your attending actually uses these criteria to make clinical decisions, they will be sure to quiz you on them! So, use one of the mnemonics below to help you remember them all and look brilliant!
|Ranson criteria for pancreatitis: at admission|
|“GA LAW” (think: “Georgia Law”- “Don’t mess with the pancreas, and don’t mess with the Georgia law!”)
To remember the numbers, I remember that this 1st set of criteria, when the patient is admitted, includes factors that are all elevated/high. Then, I memorize the #’s in this order: “20, 25, 35, 55, 16”, and match them with the “GA LAW” criteria.
|Ranson criteria for pancreatitis: initial 48 hours|
|“C & HOBBS“ (Calvin and Hobbes):
To remember the numbers, I remember that this 2nd set of criteria, 48 hours after the patient has been admitted, include some factors that are elevated/high, and some that are low (vs the 1st set, which are all high). Then, I memorize the #’s in this order: “8, 10, 6, 4, 5, 6”, and match them with the “C & HOBBS” criteria. Also, to keep the B’s straight, I remember: “4 letters w/ the # 4” for base deficit (4 letters in “base”) being increased by 4.
(courtesy of Luke Murray, another firstaidteam.com post author. Thanks, Luke!)
Ranson Criteria – “Just ABC (sort of)”
when the patient if first admitted:
- Age > 55
- AST > 250
- WBC > 16,000
- GluCose > 200
- LDH > 350
At 48 hrs
- PaO2 < 60mmHg
- BUN increased > 5
- Base Deficit > 4
- Ca < 8
- HCT decrease > 10%
- fluid sequestration > 6L
So, choose whichever of the above mnemonics fits your fancy, or invent your own! But, be sure to memorize the Ranson criteria before your 3rd year rotations; they are super high yield! I’ve been asked about them in my surgery, internal medicine, family medicine, and pediatrics clerkships!
Option 1 mnemonic: modified by me from Surgical Recall, 6th Edition- by Lorne H. Blackbourne
Ranson criteria data:
Brunicardi FC, Andersen DK, Billiar TR. Chapter 32: pancreas. In: Schwartz’s principles of surgery. 8th ed. New York, NY: McGraw-Hill; 2005.
Ranson JH, Rifkind KM, Turner JW. Prognostic signs and nonoperative peritoneal lavage in acute pancreatitis. Surg Gynecol Obstet. 1976;143:209-219.