Ranson / BISAP (acute pancreatitis)
Ranson / BISAP (acute pancreatitis) - a deterministic tool in Sophie Well's Clinical Scoring & Risk group.
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What this is
Score Ranson criteria and BISAP side by side for risk-stratifying acute pancreatitis. Ranson uses five admission factors (age >55, WBC >16, glucose >200, LDH >350, AST >250) and six 48-hour factors (hematocrit drop, BUN rise, calcium <8, PaO2 <60, base deficit >4, fluid sequestration >6 L) - higher totals correlate with higher mortality. BISAP is a five-item bedside score (BUN >25, impaired mental status, SIRS, age >60, pleural effusion) calibrated for the first 24 hours. Sophie Well computes both and reports each band. Source: Ranson JH et al. Surg Gynecol Obstet 1974;139:69-81; Wu BU et al. Gut 2008;57:1698-1703.
When to use it
Use this in the ED or on inpatient admission for a patient with confirmed acute pancreatitis to triage the level of care - floor versus step-down versus ICU - and to anticipate the need for aggressive fluid resuscitation, early enteral nutrition, or imaging for necrosis. BISAP gives an answer at the front door from data already drawn; Ranson is more discriminating but only finalizes at 48 hours, which is why most modern algorithms run BISAP at admission and reserve Ranson as the 48-hour reassessment. Neither score replaces the revised Atlanta classification, contrast-enhanced CT findings, or the clinical trajectory.
References
Ranson JH, et al. Surg Gynecol Obstet. 1974;139(1):69-81. Wu BU, et al. BISAP. Gut. 2008;57(12):1698-1703.
Worked example: Ranson 2; BISAP 2 (intermediate severity).
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