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Modified Glasgow (Imrie)
Predicts severe acute pancreatitis. Mnemonic PANCREAS, one point each. Score ≥ 3 predicts severe disease and should prompt HDU or ITU discussion. Assess within 48 hours of admission — it is not a score for the first hour, and repeating it at 48 hours is the…
What it asks
| Criterion | Points |
|---|---|
| P — PaO₂ < 8 kPa (60 mmHg) On arterial blood gas | No — 0 Yes — 1 |
| A — Age > 55 years | No — 0 Yes — 1 |
| N — Neutrophils: WBC > 15 × 10⁹/L | No — 0 Yes — 1 |
| C — Calcium < 2 mmol/L Corrected calcium | No — 0 Yes — 1 |
| R — Renal: urea > 16 mmol/L Despite rehydration | No — 0 Yes — 1 |
| E — Enzymes: LDH > 600 IU/L (or AST > 200 IU/L) | No — 0 Yes — 1 |
| A — Albumin < 32 g/L | No — 0 Yes — 1 |
| S — Sugar: glucose > 10 mmol/L In a patient without known diabetes | No — 0 Yes — 1 |
How to read the score
| Score | Means | What to do |
|---|---|---|
| 0–2 | Predicted mild to moderate | Ward-level care with aggressive fluid resuscitation, analgesia and close monitoring. Repeat the score and CRP at 48 hours — severity can declare itself late. |
| 3–8 | Predicted SEVERE | Discuss with HDU or ITU. Needs hourly urine output, careful fluid balance, and early senior surgical or gastroenterology involvement. Consider CT at 72–96 hours to assess necrosis — earlier scanning underestimates it. |
Before you use it
Assess within 48 hours, not on arrival — several criteria need time to evolve. A CRP > 150 mg/L at 48 hours is an additional independent marker of severity and is not part of this score.
Source: Blamey/Imrie modified Glasgow criteria; BSG acute pancreatitis guidance
Checked, and shown
Every threshold on this page was checked against its primary source by a practising doctor. Here is what that involved, and what it found.