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.
|
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
|
|
|
>= 60 mm Hg
|
0
|
|
acid-base
|
metabolic acidosis with base deficit > 4 mEq/L
|
1
|
|
|
metabolic acidosis with base deficit <= 4 mEq/L
|
0
|
|
|
neutral or metabolic alkalosis
|
0
|
= SUM (points for findings on admission) + (points for data
during first 24 hours)
• The higher the score the higher the mortality.
• 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.