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 Release 22.0, Sept. 2008
 
The Medical Algorithms Project
Chapter : ch11. Hepatobiliary & Pancreas Section : Diagnosis and Prognosis of Pancreatitis
  Glasgow Prognostic Criteria in Acute Pancreatitis (Imrie Criteria)

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Copyright (c) 2008-2010, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

The Glasgow system is a simple prognostic system that uses the data collected during the first 48 hours following an admission for pancreatitis. The criteria for point assignment is that a certain breakpoint be met at anytime during that 48 hour period, so that in some situations it can be calculated shortly after admission. It is applicable to both biliary and alcoholic pancreatitis.

 

The original system used 9 data elements. This was subsequently modified to 8 data elements, with removal of assessment for transaminase levels (either AST (SGOT) or ALT (SGPT) greater than 100 U/L).

 

Parameters used:

(1) age in years

(2) serum albumin

(3) PaO2 on room air

(4) serum calcium

(5) blood glucose

(6) serum LDH

(7) BUN

(8) WBC count

 

Parameter

Finding  at any time during 1st 48 hours

Points

age

> 55 years

1

 

<= 55 years

0

serum albumin

< 3.2 g/dL

1

 

>= 3.2 g/dL

0

arterial pO2 on room air

< 60 mm Hg

1

 

>= 60 mm Hg

0

serum calcium

< 8 mg/dL

1

 

>= 8 mg/dL

0

blood glucose

> 180 mg/dL

1

 

<= 180 mg/dL

0

serum LDH

> 600 U/L

1

 

<= 600 U/L

0

serum urea nitrogen

> 45 mg/dL

1

 

<= 45 mg/dL

0

WBC count

> 15,000 per µL

1

 

<= 15,000 per µL

0

 

modified Glasgow prognostic criteria =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score 0

• maximum score 8

• If the score >=3, severe pancreatitis likely.

• If the score < 3, severe pancreatitis is unlikely.

 

  References:

Blamey SL, Imrie CW, et al. Prognostic factors in acute pancreatitis. Gut. 1984; 25: 1340-1346.

Imrie CW, Benjamin IS, et al. A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis. Br J Surg. 1978; 65: 337-341.

Marshall JB. Acute pancreatitis. Arch Intern Med. 1993; 153: 1185-1198.

Osborne DH, Imrie CW, Carter DC. Biliary surgery in the same admission for gallstone-associated acute pancreatitis. Br J Surg. 1981; 68: 758-761.

Steinberg W, Tenner S. Acute pancreatitis. N Engl J Med. 1994; 330: 1198-1210.

Ventrucci M. Update on laboratory diagnosis and prognosis of acute pancreatitis. Dig Dis. 1993; 11: 189-196.

 

 
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