What is the Glasgow score for pancreatitis?

The modified Glasgow (Imrie) score has eight criteria, remembered as PANCREAS: PaO2 below 8 kPa, Age over 55, Neutrophilia (white cells above 15), Calcium below 2 mmol/L, Renal (urea above 16 mmol/L), Enzymes (LDH above 600 IU/L or AST above 200 IU/L), Albumin below 32 g/L and Sugar (glucose above 10 mmol/L). It is scored within 48 hours of admission, and a score of 3 or more predicts a severe attack.

What is the BISAP score?

BISAP is a five-point score taken in the first 24 hours: BUN above 25 mg/dL (urea above 8.9 mmol/L), Impaired mental status, SIRS, Age over 60 and Pleural effusion. A score of 3 or more is linked to a markedly higher risk of organ failure and death.

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Pancreatitis severity calculator

Creator: Dr. Mohammed Maree
Published: 2026-11-03
License: https://creativecommons.org/licenses/by-nc/4.0/

Modified Glasgow (Imrie) score, PANCREAS mnemonic, and BISAP.

Acute pancreatitis: is this attack likely to be severe?

Written and clinically reviewed by Dr. Mohammed Maree, consultant minimally invasive and bariatric surgeon, Al-Makassed Hospital, Jerusalem, and Assistant Professor of Surgery, Al-Quds University. Last updated 3 November 2026.

Why we score pancreatitis

Four out of five attacks of acute pancreatitis are mild and settle in a few days. The rest can cause organ failure, necrosis and death. Scores taken in the first 24 to 48 hours pick out the patients who need closer monitoring before they become obviously unwell.

Severity is defined by organ failure (revised Atlanta 2012)

Grade	Definition
Mild	No organ failure and no local or systemic complications
Moderately severe	Organ failure that resolves within 48 hours, or local complications (collections, necrosis), or worsening of a pre-existing disease
Severe	Organ failure that persists beyond 48 hours

So a score predicts severity; it does not define it. The final grade is decided by how the patient’s organs behave.

A worked example

A 67-year-old woman with gallstone pancreatitis. At 48 hours: age over 55, white cells 17.4, urea 18 mmol/L, glucose 12 mmol/L. Glasgow 4: predicted severe. On admission she was confused with a pulse of 112 and a temperature of 38.4 °C: BISAP has age, SIRS and impaired mental status, BISAP 3. She is discussed with critical care.

Things students get wrong

The amylase level does not predict severity and is not in any of these scores. A CRP above 150 mg/L at 48 hours is another useful marker of severity. CT is not needed for diagnosis when the story and enzymes fit; it is used after 72 hours to look for necrosis in a patient who is not improving.

References

Blamey SL, Imrie CW, et al. Prognostic factors in acute pancreatitis. Gut 1984;25:1340–6.
Wu BU, et al. The early prediction of mortality in acute pancreatitis: a large population-based study (BISAP). Gut 2008;57:1698–703.
Banks PA, et al. Classification of acute pancreatitis 2012: revision of the Atlanta classification. Gut 2013;62:102–11.
Leppäniemi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg 2019;14:27.

Educational use

This calculator is a teaching aid. It does not replace clinical judgement, senior advice or your local guidelines.

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