Glasgow-Imrie Score Calculator
Glasgow-Imrie Score Calculator
Score the eight modified Glasgow (PANCREAS) criteria at 48 hours, with the original nine-factor total shown alongside.
Glasgow-Imrie score
PANCREAS — 8 criteria → pointsPaO₂ 9.4 kPa, age 61, WBC 17.2 ×10⁹/L, calcium 2.15 mmol/L, urea 18.5 mmol/L, LDH 420 IU/L, AST 150 IU/L, albumin 35 g/L, glucose 11.8 mmol/L
PANCREAS
Predicted severe = 3 or more criteria
- P
- PaO₂ < 8 kPa (60 mmHg)
- A
- age > 55 years
- N
- neutrophils — white cell count > 15 ×10⁹/L
- C
- calcium < 2.0 mmol/L (8 mg/dL)
- R
- renal — urea > 16 mmol/L (BUN > 45 mg/dL)
- E
- enzymes — LDH > 600 IU/L or AST > 200 IU/L, one point between them
- A
- albumin < 32 g/L (3.2 g/dL)
- S
- sugar — glucose > 10 mmol/L (180 mg/dL)
Worked example
PaO₂ 9.4 kPa, age 61, WBC 17.2 ×10⁹/L, calcium 2.15 mmol/L, urea 18.5 mmol/L, LDH 420 IU/L, AST 150 IU/L, albumin 35 g/L, glucose 11.8 mmol/L
P 9.4 not < 8 (0) · A 61 > 55 (1) · N 17.2 > 15 (1) · C 2.15 not < 2.0 (0)
R 18.5 > 16 (1) · E LDH 420 not > 600 and AST 150 not > 200 (0) · A 35 not < 32 (0) · S 11.8 > 10 (1)
1 + 1 + 1 + 1 = 4 criteria → 3 or more, predicted severe
The nine-factor total is also 4 here, because the enzyme item scored zero either way
The eight criteria
| Letter | Criterion | SI threshold | Conventional |
|---|---|---|---|
| P | PaO₂ | < 8 kPa | < 60 mmHg |
| A | Age | > 55 years | > 55 years |
| N | Neutrophils — white cell count | > 15 ×10⁹/L | > 15,000/mm³ |
| C | Calcium | < 2.0 mmol/L | < 8 mg/dL |
| R | Renal — urea | > 16 mmol/L | BUN > 45 mg/dL |
| E | Enzymes — LDH or AST | LDH > 600 IU/L or AST > 200 IU/L | same |
| A | Albumin | < 32 g/L | < 3.2 g/dL |
| S | Sugar — glucose | > 10 mmol/L | > 180 mg/dL |
The three pancreatitis scores, honestly compared
| Ranson’s | Glasgow-Imrie | BISAP | |
|---|---|---|---|
| Published | 1974 | 1984 (Blamey et al) | 2008 (Wu et al) |
| Complete at | 48 hours (5 items on admission) | 48 hours | 24 hours |
| Items | 11 non-gallstone, 10 gallstone | 8 | 5 |
| Aetiology-specific | Yes — two parameter sets | No | No |
| Severe threshold | > 2 points | ≥ 3 criteria | ≥ 3 points |
| Derived against | Mortality and complications | Severe disease | In-hospital mortality |
| Discrimination | Sensitivity 87–90%, specificity 67–87% above 2 | Accuracy about 79% in the derivation | AUC 0.82, matching APACHE II |
| Needs an arterial gas | Yes (non-gallstone) | Yes | No |
| Local complications | Not derived against them | Not derived against them | Not derived against them |
| Where it is specified | Historical reference standard | UK guidance, historically | Increasingly, early triage |
Which version this page implements, and why
There is no single Glasgow score. Imrie’s group published a nine-factor prognostic system, Blamey and colleagues revised it in 1984 after 405 episodes, and by 1988 there were three versions in circulation — which is why Leese and Shaw wrote a paper comparing them. The original had nine factors. One eight-factor modification omitted age. The other omitted serum transaminase. Leese and Shaw found that transaminase was the only factor that “did not differ significantly between mild and severe outcome groups”, recommended dropping transaminase, and kept age — noting that doing so raised sensitivity and removed one emergency measurement from the admission panel.
This page implements the eight-criterion modified Glasgow score with age included, as the PANCREAS mnemonic states it. The eight are the original nine with LDH and transaminase collapsed into a single enzyme criterion satisfied by either an LDH above 600 IU/L or an AST above 200 IU/L. Age is a criterion here. If you are working from a protocol that omits age, the total will be one point lower in every patient over 55, and the severity threshold of three has not been re-derived for that version. The secondary figure beside the headline shows what the original nine-factor system would give, with LDH and AST counted as separate factors, so the difference is visible rather than something you have to take on trust.
The mnemonic is Moore’s, from 2000: PaO₂, Age, Neutrophils, Calcium, Renal, Enzymes, Albumin, Sugar. It is a retrofit — the criteria predate it by sixteen years — and it is worth knowing which letter is doing what, because two of the eight are routinely misquoted. Albumin is 32 g/L, not 30 or 35. Calcium is 2.0 mmol/L, uncorrected, not an albumin-adjusted value. Both appear as those figures in the two sources this page is built from, and reproductions giving other numbers should be treated as transcription errors until they cite something.
Like Ranson’s criteria, Glasgow-Imrie is a 48-hour score, and the same objection applies: it reports after the resuscitation decisions have been made. Its advantage over Ranson’s is that it is shorter, has no aetiology-specific variants to get wrong, and is the score UK guidance has historically specified — which is why it remains the one most British units audit against. Its disadvantage against BISAP is the day.
All three scores share a limitation that no version fixes. Each was derived against either death or a composite of severe disease, and none was derived against pancreatic necrosis, infected collections or the other local complications that determine much of the morbidity. The revised Atlanta classification of 2012 made that explicit by defining severity retrospectively: mild is no organ failure and no complications, moderately severe is transient organ failure resolving within 48 hours or local complications without persistent organ failure, and severe is persistent organ failure beyond 48 hours. A score of three or more here predicts that outcome; it does not establish it.
Frequently asked questions
Does the Glasgow-Imrie score include age?
In the version this page implements, yes — age above 55 is the A of PANCREAS. But there is a published eight-factor variant that omits age instead of transaminase. Leese and Shaw compared the three versions in 1988 and recommended keeping age and dropping transaminase, because transaminase was the only factor that did not separate mild from severe outcomes.
What Glasgow-Imrie score is severe pancreatitis?
Three or more of the eight criteria, assessed within the first 48 hours. That threshold comes from the original derivation and has not changed.
Are the albumin and calcium cut-offs 32 g/L and 2.0 mmol/L?
Yes. Albumin below 32 g/L (3.2 g/dL) and total calcium below 2.0 mmol/L (8 mg/dL), uncorrected for albumin. Both Medscape and gastrotraining.com give exactly these figures with citations; reproductions quoting other values do not.
Do LDH and AST score a point each?
No. The E of PANCREAS is a single criterion satisfied by either an LDH above 600 IU/L or an AST above 200 IU/L. Counting both is how an eight-criterion score becomes a nine-criterion one — which is what the original system actually was, and what the secondary figure above shows.
Related calculators
References
- Blamey SL, Imrie CW, O’Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis. Gut. 1984;25(12):1340–6.
- Leese T, Shaw D. Comparison of three Glasgow multifactor prognostic scoring systems in acute pancreatitis. Br J Surg. 1988;75(5):460–2.
- Moore EM. A useful mnemonic for severity stratification in acute pancreatitis. Ann R Coll Surg Engl. 2000;82(1):16–7.
- Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.
Medical Disclaimer: The tools and content provided here are for educational and reference purposes only. They are not intended to substitute for professional medical advice, diagnosis, or treatment. Clinical decisions should always be based on the comprehensive assessment of a qualified healthcare professional.