What is the Glasgow criteria for prognosis in acute pancreatitis?

Glasgow criteria or score:

The Glasgow criteria is a scoring system designed for predicting the severity of acute pancreatitis by assessing certain parameters that appears during the first 48 hours. This Glasgow score considers the following 9 parameters:

1. Age > 55 years
2. PO2 < 8 kPa (60 mmHg)
3. White blood cell count > 15 × 109 /L
4. Albumin < 32 g/L (3.2 g/dL)
5. Serum calcium < 2 mmol/L (8 mg/dL) (corrected)
6. Glucose > 10 mmol/L (180 mg/dL)
7. Urea > 16 mmol/L (45 mg/dL) (after rehydration)
8. Alanine aminotransferase > 200 U/L
9. Lactate dehydrogenase > 600 U/L

Interpretation:

• Severity and prognosis worsen as the number of these factors increases.
• More than 3 positive factors during the first 48 h suggest severe pancreatitis and a poorer prognosis.
• The Glasgow scoring system has been shown to have 80% sensitivity for predicting a severe attack, although only after 48 hours from the presentation.

Sources:

• Davidson's Principles and Practice of Medicine; 23rd Edition; page: 837; Box 21.78
• Kumar and Clark's clinical medicine, 9th Edition; Box 15.6