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    Patent Pending

    Glasgow-Imrie Criteria for Severity of Acute Pancreatitis

    Determines severity of pancreatitis based on 8 laboratory values.
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    INSTRUCTIONS

    These criteria are traditionally scored with values at 48 hours after admission.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with acute pancreatitis.

    • The Glasgow-Imrie Criteria predict severity of pancreatitis but at 48 hours after admission.
    • A severe pancreatitis episode involved death, need for surgery or complications from pancreatitis.

    Points to keep in mind:

    • The lab values are usually evaluated at 48 hours after admission, not upon admission.
    • This study was developed in the 1980s, prior to significant advances in the treatment and evaluation of pancreatitis, including advanced imaging.

    Predicting severity, mortality, and need for therapies in pancreatitis is notoriously difficult and multifactorial. Using a scoring system may help standardize treatment and allow for targeting patients in greatest danger.

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The Glasgow-Imrie Criteria are comparable to the Ranson's criteria, but both have a disadvantage of requiring a 48 hours delay before they can be appropriately applied. Studies have suggested a binary cutoff at ≥3 as suggesting a significant increase in likelihood of severe pancreatitis.

    Management

    Local management algorithms using the criteria have been published; none are validated.

    Critical Actions

    The Glasgow-Imrie Criteria require using peak laboratory values and can be appropriately applied only at 48 hours after admission.

    Formula

    Addition of selected points.

    Useful mnemonic: PANCREAS

    • PaO2< 7.9kPa
    • Age > 55 years
    • Neutrophils (WBC > 15 x 10⁹/L)
    • Calcium < 2 mmol/L
    • Renal function: Urea > 16 mmol/L
    • Enzymes LDH > 600 IU/L
    • Albumin < 32 g/L (serum)
    • Sugar (blood glucose) > 10 mmol/L

    Facts & Figures

    Score interpretation:

    Score Number of patients (in original study) Severe Pancreatitis*
    0 101 7%
    1 125 6%
    2 87 16%
    3 49 20%
    4 28 61%
    5 11 55%
    6 2 100%
    7 1 0%
    8 1 100%

    *PPV of 79% in original study

    Dr. Clem Imrie

    About the Creator

    Clem W. Imrie, MD, is a retired professor of surgery, formerly working at the Glasgow Royal Infirmary. He has received numerous awards for his research and practice involving pancreatitis, most recently the George E. Palade Prize of the International Association of Pancreatology. His research interests include the diagnosis, treatment and surgical techniques of Pancreato Biliary surgery.

    To view Dr. Clem Imrie's publications, visit PubMed