Validation of Bisap Scoring System in Predicting the Severity of Acute Pancreatitis according to the Latest Atlanta Classification

Abstract

Acute pancreatitis (AP) is an inflammatory condition of the pancreas with a clinical course hat varies from mild to severe, leading to activation of pancreatic enzyme and causing selfdigestion of the pancreas. The overall mortality rate of AP is 2–5%, but the mortality of severe acute pancreatitis (SAP) may range upto 20–30%. So it is important to assess the disease severity in a timely and accurate manner There are variety of score systems such as Ransom’s criteria[1], Acute Physiology and Chronic Health Evaluation (APACHE) II [2] and Computed Tomography Severity Index (CTSI). But these systems have their own distinct pros and cons. A new mortality based prognostic scoring system for use in acute pancreatitis has been derived and validated which was named the Bedside Index of Severity in Acute Pancreatitis (BISAP). The 5­point BISAP score system incorporates the variables: Blood urea nitrogen level >25 mg/dl, Impaired mental status, Systemic inflammatory response syndrome (SIRS), and age > 60years, and presence of pleural effusion. Thus the BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24h of presentation.