Predicts outcome in acute pancreatitis.
Modified Glasgow Imrie Severity Calculator
About the Calculator
The Glasgow Imrie score is a modification of Ranson’s criteria used to predict the outcome in acute pancreatitis. Originally composed of 9 factors, it was later reduced to 8 components due to superior predictive value. A score of three or more positive criteria, based on blood tests taken on admission and repeated within 48 hours, is indicative of severe pancreatitis and may require transfer to a higher acuity unit.
A score is determined by assigning one point for each of the criteria outlined below.
Criteria for Calculation:
Check the box if the criterion is met:
References
- Imrie CW. Prognosis of acute pancreatitis. Annali Italiani di Chirurgia 1995, 66 (2): 187-9
- Moore EM. A useful mnemonic for severity stratification in acute pancreatitis. Annals of the Royal College of Surgeons of England 2000, 82 (1): 16-7
The Modified Glasgow (Imrie) Criteria is a clinical scoring system used to predict the severity of Acute Pancreatitis. Originally developed by Dr. Colin Imrie in 1978 and later refined, it identifies patients at high risk for developing pancreatic necrosis, multi-organ failure, or death.
Unlike the Ranson Criteria, which requires assessments at two different time points (admission and 48 hours), the Glasgow score can be calculated at any time within the first 48 hours of admission, making it a dynamic and practical tool for inpatient monitoring (Taylor et al., 2005).
The 8 Scoring Criteria
The Glasgow score assigns 1 point for each of the following eight variables if they meet the threshold within the first 48 hours of hospitalization.
The "PANCREAS" Mnemonic
A common way to remember the criteria is through the mnemonic PANCREAS:
| Letter | Variable | Threshold Value |
| P | $PaO_2$ (Oxygen) | $< 60$ mmHg ($< 8$ kPa) |
| A | Age | $> 55$ years |
| N | Neutrophils (WBC) | $> 15 \times 10^9/L$ |
| C | Calcium | $< 2$ mmol/L ($< 8$ mg/dL) |
| R | Renal (Urea) | $> 16$ mmol/L ($> 45$ mg/dL) |
| E | Enzymes (LDH) | $> 600$ units/L |
| A | Albumin | $< 32$ g/L |
| S | Sugar (Glucose) | $> 10$ mmol/L ($> 180$ mg/dL) |
Note: Unlike some other scores, serum amylase levels are not included in the severity criteria, as the height of amylase elevation does not correlate with the severity of the disease.
Clinical Interpretation
The total score ranges from 0 to 8.
- Score 0 – 2: Indicates Mild Acute Pancreatitis. The risk of severe complications is low, and the patient can typically be managed on a general medical ward.
- Score $\ge$ 3: Indicates Severe Acute Pancreatitis. These patients have a significantly higher risk of pancreatic necrosis and organ failure. They should be considered for admission to a High Dependency Unit (HDU) or Intensive Care Unit (ICU) for aggressive fluid resuscitation and monitoring (Blamey et al., 1984).
Glasgow vs. Ranson vs. APACHE II
The Glasgow score is frequently compared to other predictive models:
- Vs. Ranson: Glasgow is often considered easier to use because it does not require a specific "at 48 hours" data point; any value meeting the threshold within that window counts.
- Vs. APACHE II: While APACHE II is slightly more accurate, it is far more complex (requiring 12 variables and physiological constants), making the Glasgow score the preferred "bedside" tool for many clinicians.
- Etiology: The Glasgow score is validated for both gallstone-induced and alcohol-induced pancreatitis, whereas the original Ranson criteria had separate scales for each (Osborne et al., 1981).
References
- Imrie, C. W., et al. (1978). A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis. British Journal of Surgery, 65(5), 337-341.
- Blamey, S. L., et al. (1984). Prognostic factors in acute pancreatitis. Gut, 25(12), 1340-1346. https://doi.org/10.1136/gut.25.12.1340
- Osborne, D. H., et al. (1981). A critical assessment of data prediction of severity in acute pancreatitis. British Journal of Surgery, 68(11), 758-761.
- Taylor, S. L., et al. (2005). A comparison of the Ranson and Glasgow severity scores in an American cohort. Journal of Clinical Gastroenterology, 39(2), 154-157.
