Question

The severity of an acute pancreatitis episode can be assessed using two tools:

(1) Ranson/Imrie criteria and (2) modified Glasgow criteria. Describe each of these tools.

Answer 1

Ransons Crieria on admission

• Age greater than 55 years.
• A WBC count greater than 16000
• Blood Glucose >11 mmol/L
• Serum LDH>350 IU /L
• Serum AST >250 IU /L

Ransons Criteria after 48 hours of admission.

• Fall in hematocrit by more than 10%
• Fluid sequestration of >6L
• Hypocalcaemia <8.0mg/dl
• Hypoxaemia (PO2<60mmHg)
• Increase in BUN to >1.98 mmol/L after IV fluid hydration.
• Base deficit of >4mmol/L

The prognostic implications of Ransons Criteria are as follows

• Score 0 to 2 .2% mortality.
• Score 3 to 4 15 mortality
• Score 5 to 6 40% mortality
• Score 7 to 8 100%mortality.

Modified Glas gow criteria

This is neurological scale which gives patient a score between 3-14 depending on their level of consciousness.the scale is composed of 3 tests Eye response,verbal response and Motor response.

Eye opening

• No eye opening=1
• Eye opening in response to pain stimulus=2
• Eye opening to speech=3
• Eye opening to spontaneously=4

Verbal Response

• No verbal response.=1
• Incomprehensible sounds.=2
• Inappropriate words.=3
• Confusion=4
• Oriented.=5

Motor Response

• No motor response=1
• Decerebrate posturing accentuated by pain.=2
• Decorticate posturing accentuated by pain =3
• Withdrawl from pain.=4
• Localizes to pain =5
• Obeys command.=6