Glasgow–Imrie score (acute pancreatitis)
Severity prediction in acute pancreatitis within 48 hours (any aetiology)
Sources last checked: 2026-10-13
Glasgow–Imrie score (acute pancreatitis)
Severity prediction in acute pancreatitis within 48 hours (any aetiology)
8 % of episodes with fewer than 3 factors were severe in the prospective series.
Scored on the worst values within 48 h of admission. The original nine-factor version also counted AST > 200 U/L; the 1984 modification dropped the factor that did not predict severity. Positive predictive value is modest.
Interpretation
| 0–2 — severe disease not predicted | 8 % of episodes with fewer than 3 factors were severe in the prospective series. |
|---|---|
| ≥ 3 — severe pancreatitis predicted | 31 % of episodes with 3 or more factors were severe (high-risk category). |
What is the Glasgow–Imrie score (acute pancreatitis)?
The modified Glasgow (Imrie) score uses eight laboratory and clinical factors within 48 hours of admission to predict severe acute pancreatitis of any cause. It was developed at Glasgow Royal Infirmary by Imrie and colleagues and prospectively assessed by Blamey et al. in 1984 in 405 episodes. Three or more positive factors predict a severe attack.
When to use it
- Severity prediction in acute pancreatitis of biliary or alcoholic origin
- Early identification of patients at risk of a severe attack
- Comparing severity across patient series
When not to use it
- As a diagnosis of severe pancreatitis — severity is defined by persistent organ failure (revised Atlanta)
- Single time-point decisions at the door — the score is designed for the first 48 h
How it is calculated
| Criterion | Points |
|---|---|
| PaO₂ < 8 kPa (< 60 mmHg) | +1 |
| Age > 55 years | +1 |
| WBC > 15 × 10⁹/L | +1 |
| Calcium < 2.0 mmol/L (< 8 mg/dL) | +1 |
| Urea > 16 mmol/L (BUN > 45 mg/dL) | +1 |
| LDH > 600 U/L | +1 |
| Albumin < 32 g/L | +1 |
| Glucose > 10 mmol/L (> 180 mg/dL), no known diabetes | +1 |
Clinical pearls and limitations
- Scored on the worst values within 48 h of admission. The original nine-factor version also counted AST > 200 U/L; the 1984 modification dropped the factor that did not predict severity. Positive predictive value is modest.
- Mnemonic PANCREAS: PaO₂, Age, Neutrophils (WBC), Calcium, Renal (urea), Enzymes (LDH), Albumin, Sugar.
- Use the worst value in the first 48 h for each factor.
- Glucose counts only in patients without known diabetes.
- Positive predictive value is limited (31 % severe with ≥ 3 factors in Blamey's series); negative predictive value is better.
Frequently asked questions
What is the Glasgow-Imrie score cut-off?
Three or more factors within 48 h predict severe acute pancreatitis.
Is the Glasgow score the same as Ranson's?
No. Glasgow uses eight SI-based factors valid for any aetiology, including albumin and urea; Ranson uses 11 criteria with separate sets for gallstone pancreatitis.
Does the Glasgow-Imrie score include AST?
The original nine-factor version did; the 1984 modified eight-factor score does not.
Evidence and guidelines
- Primary source: Blamey SL, Imrie CW, O'Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis. Gut 1984;25(12):1340-1346 (eight-factor modified Glasgow score; ≥ 3 factors = severe). SI thresholds as tabulated in open-access reviews (e.g. PMC9727576).
- Imrie CW et al. A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis. Br J Surg 1978;65(5):337-341 (original nine-factor Glasgow criteria, including AST).
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