Bedside Index of Severity in Acute Pancreatitis (BISAP) score for predicting prognosis in acute pancreatitis

Introduction: Bedside Index of Severity in Acute Pancreatitis (BISAP) is a simple bedside tool which helps in early identification of risk of higher mortality in acute pancreatitis. Objectives: Our aim was to study clinical and laboratory profiles of patients with acute pancreatitis presenting to a tertiary care hospital in Mumbai, India and to stratify patients according to their risk of mortality by applying the BISAP score and its correlation with Computed Tomography Severity Index (CTSI). Material and methods: Patients who came to Lokmanya Tilak Municipal Medical College (LTMMC) and General Hospital, Mumbai with definitive features of acute pancreatitis from January, 2013 to April, 2013 were prospectively observed for 24 hours and their clinical information was collected. CT abdomen was used as the gold standard for the diagnosis of acute pancreatitis. Descriptive analysis for various patient variables was performed using SPSS. Results: Alcoholism was the most common etiology; 97% patients presented with abdominal pain. Higher serum amylase, lipase and blood urea nitrogen levels, hypocalcemia, presence of systemic inflammatory response syndrome and bilateral pleural effusion were found to significantly associate with mortality. There was a statistically significant trend for increasing mortality with increasing BISAP score (p<0.001). However, no significant correlation between BISAP score and CTSI was found [(p = 0.101), Pearson’s correlation coefficient = 0.168]. Conclusion: Traditional severity indices have not been clinically useful since they require collection of huge amount of clinical and laboratory data over time. In such circumstances, BISAP score can predict patients who are at higher risk of mortality.