For healthcare professionals
Ranson criteria calculator (acute pancreatitis)
Ranson's criteria count 11 prognostic signs in acute pancreatitis: 5 measured at admission and 6 during the first 48 hours, 1 point each. This calculator gives the admission score, or the full score once the 48-hour values are in, and whether it reaches the cut point of 3. It is written for clinicians and is not a diagnosis.
Prognostic signs
For an adult with acute pancreatitis that is not caused by gallstones (the original 1974 set). The gallstone thresholds are in the table below. Nothing you enter leaves this page.
At admission
During the first 48 hours
What you will see
The admission score out of 5, or the full Ranson score out of 11, the signs that scored, and whether the total reaches 3, the cut point used to predict severe acute pancreatitis.
Educational only, not medical advice. Not a diagnosis and not a treatment decision.
Source
Ranson JH and colleagues, Surg Gynecol Obstet 1974 (the original criteria); the gallstone version is cited to Ranson, Ann Surg 1979. Items and cut points as printed in Table 4 of Lee and Cho, 2022 (open access); SI units and the cut point of 3 as stated by Chen and colleagues, 2026 (open access). The tests check every item, the admission-only score and the cut point.
Validated in
Developed in patients with acute pancreatitis; the original set was designed mainly for alcohol-related pancreatitis, and a separate set was later adapted for gallstone (biliary) pancreatitis (Lee and Cho 2022). Later studies have tested it in many hospital cohorts.
Limits
The full score needs 48 hours, so it cannot grade severity at admission and may delay early treatment decisions (Lee and Cho 2022). Several items, such as base deficit and fluid sequestration, are not routinely measured. Thresholds differ for gallstone pancreatitis. It predicts severity; it does not diagnose pancreatitis or its cause.
Ranson criteria and cut points
Each sign present scores 1 point. The original set has 5 signs at admission and 6 during the first 48 hours, for a total from 0 to 11 (Lee and Cho 2022) (Chen 2026). The gallstone column is the biliary version printed in the same source table (Lee and Cho 2022) (Ranson 1979).
| Sign | Not gallstone (alcohol or other) | Gallstone (biliary) |
|---|---|---|
| At admission | ||
| Age | Over 55 years | Over 70 years |
| White cell count | Over 16,000 per mm³ | Over 18,000 per mm³ |
| LDH | Over 350 U/L | Over 400 U/L |
| AST | Over 250 U/L | Over 250 U/L |
| Glucose | Over 200 mg/dL | Over 220 mg/dL |
| During the first 48 hours | ||
| Hematocrit fall | More than 10% | More than 10% |
| BUN rise | More than 5 mg/dL | More than 2 mg/dL |
| Serum calcium | Under 8 mg/dL | Under 8 mg/dL |
| PaO₂ | Under 60 mmHg | Under 60 mmHg |
| Base deficit | Over 4 mEq/L | Over 4 mEq/L |
| Fluid sequestration | Over 6 L | Over 4 L |
The calculator scores the original (not gallstone) set, which is listed the same way in several open sources (Lee and Cho 2022) (Chen 2026). For the gallstone version, the source's text describes five 48-hour factors while its table lists six, so we show the table for reference and do not score it here (Lee and Cho 2022). In SI units, the glucose cut point is 11.1 mmol/L, the BUN rise 1.79 mmol/L and the calcium cut point 2.0 mmol/L (Chen 2026).
Reading the total
A total of 3 or more is the cut point used to predict severe disease (Chen 2026). In a 2022 review, the reported accuracy for predicting severe acute pancreatitis was 0.81 to 0.88 at a Ranson score of 3 or more, and the area under the curve was 0.84 for organ failure, 0.56 for necrosis, 0.80 for mortality and 0.81 for severity (Lee and Cho 2022). Because the score needs 48 hours, the authors note its limited use for grading severity at admission (Lee and Cho 2022). A score of 3 or more already at admission reaches the same cut point; a lower admission score can still rise once the 48-hour signs are counted.
Related tools
For other clinician scores on this site, see the BISAP score calculator, a 5-item acute pancreatitis score from the first 24 hours, the SOFA score calculator for organ dysfunction, the qSOFA score calculator, the Glasgow-Blatchford score for upper GI bleeding and the Alvarado score calculator for suspected appendicitis.
Sources
- Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69-81. PMID 4834279. Original description of the 11 prognostic signs. pubmed.ncbi.nlm.nih.gov/4834279/
- Ranson JH. The timing of biliary surgery in acute pancreatitis. Ann Surg. 1979;189(5):654-663. doi:10.1097/00000658-197905000-00016. PMID 443917. Source cited for the gallstone (biliary) version of the criteria. pubmed.ncbi.nlm.nih.gov/443917/
- Lee DW, Cho CM. Predicting severity of acute pancreatitis. Medicina (Kaunas). 2022;58(6):787. doi:10.3390/medicina58060787. Open access (CC BY). Section 5.1 and Table 4 (Ranson criteria, non-biliary and biliary), section 5.4 and Table 6 (BISAP), section 5.7 (comparison of scoring systems). pmc.ncbi.nlm.nih.gov/articles/PMC9227091/
- Chen Z, Liu MX, et al. Comparison of clinical characteristics and predictive performance of severity scoring systems in hypertriglyceridemic versus non-hypertriglyceridemic acute pancreatitis: a retrospective cohort study. Arch Endocrinol Metab. 2026;70(5):e260103. doi:10.20945/2359-4292-2026-0103. Open access (CC BY). Methods (Ranson criteria with SI units and the cut point of 3; BISAP items, SIRS definition and the cut point of 3). pmc.ncbi.nlm.nih.gov/articles/PMC13587624/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-01. Spotted an error? See About.