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BISAP Score

Bedside Index for Severity in Acute Pancreatitis — First 24 Hours

A 5-parameter bedside score assessed within the first 24 hours of admission for acute pancreatitis. Predicts in-hospital mortality with accuracy comparable to more complex scores (APACHE-II).

General Surgery Pancreatitis Critical Care
BISAP Score — Within First 24 Hours

All criteria assessed within the first 24 hours

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BISAP Score / 5
Select criteria above and calculate

Score & Mortality

ScoreMortalityRisk LevelSetting
0 <1% Very Low Ward
1 ~1.2% Low Ward
2 ~3.4% Moderate HDU
3 ~10% High ICU
4 ~25% Very High ICU
5 ~37% Critical ICU

SIRS Criteria

SIRS is present if ≥2 of the following are met:
Temperature <36°C or >38°C  ·  Heart rate >90 bpm  ·  Respiratory rate >20 breaths/min or PaCO₂ <32 mmHg  ·  WBC <4×10&sup9;/L or >12×10&sup9;/L

Clinical Application

  • BISAP was derived from a US nationwide database (Wu et al. 2008; n=17,992)
  • Outperforms Ranson's criteria in simplicity while matching predictive accuracy
  • Score ≥3 at 24h: immediate HDU/ICU consideration; aggressive fluid resuscitation (Ringer's Lactate preferred 250–500 mL/h initial)
  • BUN >25 mg/dL at 24h independently predicts organ failure and mortality
  • Pleural effusion on CXR or CT indicates significant third-space fluid loss and systemic inflammation
  • Combine BISAP (24h) with Glasgow Score (48h) and Modified CTSI (CT-based) for full severity assessment
  • Complement with HAPS at admission for early stratification in the ED

References

  1. Wu BU, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Arch Intern Med. 2008;168(17):1961–1969.
  2. Singh VK, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol. 2009.
  3. Papachristou GI, et al. Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010.

Related Calculators

HAPS Score Glasgow Score Modified CTSI Ranson's Criteria