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 Release 22.0, Sept. 2008
 
The Medical Algorithms Project
Chapter : ch11. Hepatobiliary & Pancreas Section : Diagnosis and Prognosis of Pancreatitis
  Scoring System of Blamey et al for Separating Gallstone from Alcoholic Pancreatitis

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

Overview :

Blamey et al identified clinical and laboratory factors associated with gallstone pancreatitis. This can help separate patients with gallstones from those with nongallstone pancreatitis. The authors are from the Royal Infirmary and Glasgow University in Glasgow.

 

Parameters:

(1) gender

(2) age

(3) serum amylase

(4) serum ALT

(5) serum alkaline phosphatase

 

Parameter

Finding

Points

gender

male

0

 

female

1

age

< 50 years of age

0

 

>= 50 years of age

1

serum amylase

< 4,000 IU/L

0

 

>= 4,000 IU/L

1

serum ALT

< 100 IU/L

0

 

>= 100 IU/L

1

serum alkaline phosphatase

< 300 IU/L

0

 

>= 300 IU/L

1

 

simple score =

= SUM(points for the 5 risk factors)

 

Interpretation:

• minimum total score: 0

• maximum total score: 5

• The higher the score the greater the probability of gallstone pancreatitis.

 

number of risk factors

Group A

Prospective Group

0

5%

0%

1

4%

11%

2

55%

55%

3

86%

82%

4

95%

88%

5

100%

100%

from Tables 3 and 5

 

Probability of Gallstones Based on Individual Risk Factors

 

Gender

Age

Amlyase

ALT

Alk Phos

Probability Gallstones

0

0

0

0

0

0.02

0

0

0

0

1

0.08

0

0

0

1

0

0.10

0

0

0

1

1

0.34

0

0

1

0

0

0.06

0

0

1

0

1

0.24

0

0

1

1

0

0.29

0

0

1

1

1

0.66

0

1

0

0

0

0.19

0

1

0

0

1

0.52

0

1

0

1

0

0.58

0

1

0

1

1

0.87

0

1

1

0

0

0.46

0

1

1

0

1

0.80

0

1

1

1

0

0.84

0

1

1

1

1

0.96

1

0

0

0

0

0.16

1

0

0

0

1

0.48

1

0

0

1

0

0.54

1

0

0

1

1

0.85

1

0

1

0

0

0.42

1

0

1

0

1

0.77

1

0

1

1

0

0.81

1

0

1

1

1

0.95

1

1

0

0

0

0.72

1

1

0

0

1

0.92

1

1

0

1

0

0.94

1

1

0

1

1

0.99

1

1

1

0

0

0.90

1

1

1

0

1

0.98

1

1

1

1

0

0.98

1

1

1

1

1

0.996

from Table 2, page 576

 

Limitations:

• The laboratory methods (amylase, ALT and alkaline phosphatase) will usually be different between institutions and the cut-off points may need to be adjusted. The methods and reference ranges were not given.

 

  References:

Blamey SL, Osborne DH, et al. The early identification of patients with gallstone associated pancreatitis using clinical and biochemical factors only. Ann Surg. 1983; 198; 574-578.

 

 
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