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Overview :
Acute pancreatitis can be a serious disease, which can result
in death. It is possible to identify those patients with poor prognosis by
analysis of their laboratory data using the factors identified by Ransom.
Parameters on admission:
(1) age
(2) WBC count
(3) blood glucose
(4) serum LDH
(5) serum AST
Parameters within first 24 hours after admission:
(6) serum calcium
(7) hematocrit
(8) BUN
(9) arterial pO2
(10) acid base status
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Data on
Admission |
Finding |
Points |
|
age |
> 55 years of age |
1 |
|
|
<= 55 years of age |
0 |
|
WBC count |
> 16,000 per µL |
1 |
|
|
<= 16,000 per µL |
0 |
|
blood glucose |
> 200 mg/dL |
1 |
|
|
<= 200 mg/dL |
0 |
|
serum LDH |
> 350 U/L |
1 |
|
|
<= 350 U/L |
0 |
|
serum AST |
> 250 U/L |
1 |
|
|
<= 250 U/L |
0 |
|
Data Within
First 24 Hours |
Finding |
Points |
|
serum calcium |
< 8 mg/dL |
1 |
|
|
>= 8 mg/dL |
0 |
|
hematocrit |
fall from admission by > 10% |
1 |
|
|
no fall from admission |
0 |
|
|
fall from admission by <= 10% |
0 |
|
BUN |
increase from admission by > 5 mg/dL |
1 |
|
|
no increase from admission |
0 |
|
|
increase from admission by <= 5 mg/dL |
0 |
|
arterial pO2 |
< 60 mm Hg |
1 |
|
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>= 60 mm Hg |
0 |
|
acid-base |
metabolic acidosis with base deficit > 4
mEq/L |
1 |
|
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metabolic acidosis with base deficit <= 4
mEq/L |
0 |
|
|
neutral or metabolic alkalosis |
0 |
score =
= SUM (points for findings on admission) + (points for data
during first 24 hours)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the higher the mortality.
|
Score |
Mortality |
|
<=2 |
1% |
|
3 - 4 |
15% |
|
5 - 6 |
40% |
|
>= 7 |
100% |
Limitations:
• It may be difficult to collect all of the data
required.
• It requires 48 hours to collect the information.
• It is affected by the etiology of the pancreatitis.
• It is affected by the treatment given.
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