Clicky

TabletWise.com
Pharmacy Website
Clinic Website
 
 

BISAP Score for Pancreatitis Mortality

Calculators  Endocrine
The Bedside Index of Severity in Acute Pancreatitis (BISAP) Score determines one's likelihood of dying from pancreatitis. Blood urea nitrogen, age, mental status, the presence of pleural effusions, and the body's response to infection are all factored into this score.
BUN >25 mg/dL
No 0
Yes 1
Impaired mental status
Defined as disorientation, somnolence, lethargy, coma or stupor
No 0
Yes 1
No 0
Yes 1
Age >60 years
No 0
Yes 1
Pleural effusion present
No 0
Yes 1
Result:

Background

Measured Factor
BISAP Score
Measured Factor Disease
  • Mortality from acute pancreatitis
Measured Factor Detail
The BISAP Score predicts a patient with pancreatitis' risk for mortality. The score is important as most individuals want to keep their risk for death as low as possible. The pancreas assists in breaking down food before absorption and secreting insulin. With pancreas dysfunction, malnutrition and diabetes may ensue.
Speciality
Endocrinologist
Body System
Endocrine
Formula
N/A
Measured Factor Low Impact
  • Lower risk of mortality from acute pancreatitis
Measured Factor High Impact
  • Higher risk of mortality from acute pancreatits
Process
N/A
Preparation
  • N/A

Result Interpretation

Ranges Ranges
  • Critical Low: 0-2 points
  • Critical High: 3-5 points
  • Normal: 0 points
  • Normal Adult Male: N/A
  • Normal Adult Female: N/A
  • Normal Pediatric: N/A
  • Normal Neonate Female: N/A
  • Normal Geriatric Male: N/A
  • Normal Geriatric Female: N/A
Result Low Conditions
  • N/A
Result High Conditions
  • Acute pancreatitis
False Positive
  • High blood urea nitrogen
  • sepsis
  • impaired mental cognition
  • old age
  • presence of pleural effusion
References: 2
Test Limitations
N/A
References: 2

Studies

Study Validation 1
The Bedside Index for Severity in Acute Pancreatitis Score can predict a patient’s mortality from acute pancreatitis within 24 hours of onset. This study aimed to evaluate how well the score predicts mortality in acute pancreatitis. Between June 2005 and December 2007, all patients admitted or transferred to the facility with acute pancreatitis were enrolled in the study. This included 339 patients with 397 hospitalizations. 14 patients died. An increased Bedside Index for Severity in Acute Pancreatitis Score correlated with increased mortality. This finding was statistically significant. Those with a score greater than or equal to 3 experienced an increased risk of organ failure, persistent organ failure, and pancreatic necrosis.
References: 3
Study Validation 2
The Bedside Index for Severity in Acute Pancreatitis Score, the Acute Physiology and Chronic Health Evaluation II, and the Ranson Scoring Systems are used in assessing the severity of acute pancreatitis. The BIASP Score has been studied in Western populations but not in China. Between January 2010 and June 2013, 155 patients at a tertiary care center in China with acute pancreatitis were included at the study. This was a retrospective study. The acute pancreatitis was secondary to a variety of causes including alcohol, biliary stones, and hyperlipidemia. Of the 155 patients, 6 died during hospitalization and 24 patients developed pancreatic necrosis. An increased Bedside Index for Severity in Acute Pancreatitis Score correlated with increased disease severity and mortality. This finding was statistically significant.
References: 4
Study Validation 3
The Atlanta classification for acute pancreatitis had been recently revised in 2014. This system categorizes the severity of one’s acute pancreatitis. This study aims to look at this revised classification system. 163 acute pancreatitis patients were followed for up to 6 months after discharge. 53.4% of these patients had mild acute pancreatitis, 35.6% had moderate, and 11.04% had severe pancreatitis. Outcomes were significantly higher in moderate patients than in mild. The utility of the revised Atlanta classification for acute pancreatitis was proven.
References: 5
Study Additional 1
The Bedside Index for Severity in Acute Pancreatitis Score, the Acute Physiology and Chronic Health Evaluation II, modified Computed Tomography Severity Index, and the Ranson Scoring Systems are used in assessing the severity of acute pancreatitis. The Atlanta classification system has not been commonly compared to these scoring systems. Between March 2015 and September 2016, 50 patients at a tertiary care center in India with acute pancreatitis were included at the study. This was a prospective study. 14 patients were classified as having severe acute pancreatitis. 14 patients experienced persistent organ failure and 15 experienced pancreatic necrosis. The modified Computed Tomography Severity Index was the most predictive of organ failure and ICU admission. The Ranson’s Score was the second most accurate in predicting ICU admission. APACHE II Score was the second most accurate in predicting organ failure.
References: 6
Study Additional 2
The Bedside Index for Severity in Acute Pancreatitis Score can be done during a patient’s admission to predict the severity of his/her acute pancreatitis. After its classifications, appropriate interventions can be rapidly made. This study evaluated the clinical utility of the Bedside Index for Severity in Acute Pancreatitis Score and procalcitonin in acute pancreatitis classification. Between July 2015 and June 2016, 60 acute pancreatitis patients were enrolled in the study at XXX Medical College and Hospital.  This was a prospective, observational study. Most of the patients experienced acute pancreatitis secondary to alcohol and gallstones. 14 patients (23.3%) had severe acute pancreatitis. 21 patients experienced pancreatic necrosis. 7 patients (11.6%) died. This scoring system is comparable to the utility found with the Acute Physiology and Chronic Health Evaluation II. This scoring system is more accurate than Ranson’s criteria, computed tomography severity index, c-reactive protein, hematocrit, and body mass index.
References: 7
Study Additional 3
Scoring can be done during a patient’s admission to predict the severity of his/her acute pancreatitis. After its classifications, appropriate interventions can be rapidly made. This study evaluated the clinical utility of several different scores used in acute pancreatitis classification. 343 acute pancreatitis patients were enrolled in the study. 170 patients had severe acute pancreatitis. 61 patients died. 96 patients experienced pancreatic necrosis. The Acute Physiology and Chronic Health Evaluation II Score and the Bedside Index for Severity in Acute Pancreatitis Score are comparably predictive.
References: 8

Authors

Bechien U. Wu
MD, Brigham and Women's Hospital in Boston
Gastroenterologist, Kaiser Permanente Los Angeles Medical Center
N/A
N/A
N/A
N/A

References

  1. Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA.The early prediction of mortality in acute pancreatitis: a large population-based study.Gut. 2008 Dec;57(12):1698-703
  2. N/A
  3. Singh VK, Wu BU, Bollen TL, Repas K, Maurer R, Johannes RS, Mortele KJ, Conwell DL, Banks PA. 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 Apr;104(4):966-71.
  4. Zhang J, Shahbaz M, Fang R, Liang B, Gao C, Gao H, Ijaz M, Peng C, Wang B, Niu Z, Niu J.Comparison of the BISAP scores for predicting the severity of acute pancreatitis in Chinese patients according to the latest Atlanta classification.J Hepatobiliary Pancreat Sci. 2014 Sep;21(9):689-94.
  5. Talukdar R, Bhattacharrya A, Rao B, Sharma M, Nageshwar Reddy D.Clinical utility of the revised Atlanta classification of acute pancreatitis in a prospective cohort: have all loose ends been tied? Pancreatology. 2014 Jul-Aug;14(4):257-62.
  6. Harshit Kumar A, Singh Griwan M. A comparison of APACHE II, BISAP, Ranson's score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification.Gastroenterol Rep (Oxf). 2018 May;6(2):127-131.
  7. Hagjer S, Kumar N. Evaluation of the BISAP scoring system in prognostication of acute pancreatitis - A prospective observational study. Int J Surg. 2018 Jun;54(Pt A):76-81.
  8. Vasudevan S, Goswami P, Sonika U, Thakur B, Sreenivas V, Saraya A. Comparison of Various Scoring Systems and Biochemical Markers in Predicting the Outcome in Acute Pancreatitis. Pancreas. 2018 Jan;47(1):65-71.