Glasgow-Imrie Criteria for Severity of Acute Pancreatitis

Why Use

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.

When to Use

Patients with acute pancreatitis.

Formula

Pearls / Pitfalls

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.

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.

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.

More Information

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