The Bedside Index for Severity in Acute Pancreatitis (BISAP) score is a simple and reliable clinical tool used to predict the severity and risk of complications in patients with acute pancreatitis. Developed to provide a fast, bedside evaluation method, the BISAP score allows healthcare professionals to assess a patient's condition within the first 24 hours of hospital admission using five easily measurable criteria. Each criterion contributes one point to the total score, resulting in a range from 0 to 5.
Acute pancreatitis can range from a mild, self-limited condition to a severe, life-threatening illness. Prompt identification of patients who are at risk of developing organ failure or dying is crucial for effective clinical management. The BISAP score was designed to address this need by offering a scoring system that does not rely on complex laboratory tests or long observation periods.
The five criteria used in the BISAP score include:
The total score helps physicians estimate the patient's risk of severe pancreatitis or mortality. For example, a BISAP score of 0 to 1 generally indicates a low risk, while a score of 3 or higher suggests a significantly increased likelihood of complications or death.
One of the key advantages of the BISAP score is that it can be quickly calculated at the bedside without the need for advanced diagnostics. This makes it especially useful in emergency departments, intensive care units, and resource-limited settings. In practice, it supports clinical decision-making by guiding the level of care needed—whether the patient requires close monitoring, admission to intensive care, or transfer to a specialized center.
The BISAP Score Calculator is designed to be a quick and easy tool to help assess the severity of acute pancreatitis using five key clinical criteria. Each criterion is represented as a checkbox on the calculator form. You simply check the box if the condition is true for the patient. Each checked box contributes 1 point to the total BISAP score.
Here’s how each part works:
Once you’ve selected all applicable criteria, click the “Calculate” button. The calculator will instantly display the BISAP score, ranging from 0 to 5. Each positive finding equals one point.
The BISAP Score Calculator should be used within the first 24 hours of hospital admission for a patient with suspected or confirmed acute pancreatitis. It is especially useful for emergency room doctors, hospitalists, and critical care providers who need to make quick decisions about a patient’s level of care.
Using the calculator early helps in:
The BISAP score is calculated based on five simple clinical criteria. Each criterion, if present, adds one point to the total score. The maximum score is 5. A higher BISAP score indicates a greater risk of complications or death in patients with acute pancreatitis.
Elevated blood urea levels can indicate impaired kidney function or dehydration, which are both associated with more severe pancreatitis. If the patient’s serum urea is greater than 8.9 mmol/L (or 25 mg/dL), this criterion is marked as positive.
The Glasgow Coma Scale (GCS) is used to assess a patient’s level of consciousness. A score below 15 suggests altered mental status, which may reflect severe systemic illness or complications affecting the brain. This is a warning sign that the disease may be more serious.
SIRS is a widespread inflammatory reaction in the body and is identified by meeting at least two of the following criteria:
The presence of SIRS indicates that the body is experiencing significant inflammation, which can lead to organ dysfunction if not managed appropriately.
Older age is associated with a higher risk of complications in acute pancreatitis. Patients over 60 are more likely to develop severe forms of the disease and are given one point in the BISAP score if they meet this age criterion.
Pleural effusion is the accumulation of fluid between the layers of tissue lining the lungs and chest cavity. Its presence, detected through imaging such as a chest X-ray or CT scan, suggests more advanced disease and is associated with a poorer prognosis.
Together, these five factors help clinicians assess the potential severity of acute pancreatitis quickly and accurately, allowing for timely medical intervention.
The BISAP score ranges from 0 to 5, with each point representing one of the five risk factors present in a patient with acute pancreatitis. The higher the score, the greater the risk of serious complications, including organ failure and death.
This scoring system helps medical professionals identify high-risk patients early, allowing for closer monitoring and more aggressive treatment when necessary. Here's what each score generally indicates:
| BISAP Score | Interpretation | Risk Level |
|---|---|---|
| 0 | No risk factors present. Low likelihood of complications. | Low |
| 1 | One risk factor present. Still a low chance of severe outcome, but requires standard observation. | Low |
| 2 | Moderate risk of developing complications. Requires closer monitoring. | Moderate |
| 3 | High risk of severe pancreatitis. Increased likelihood of organ failure or ICU admission. | High |
| 4–5 | Very high risk. Strong association with severe disease and mortality. Intensive care is often needed. | Very High |
To better understand the BISAP score, it's important to know what some of the medical terms mean. Here are simple explanations of the key concepts used in the score:
SIRS is the body’s overwhelming response to an infection, injury, or illness that can lead to widespread inflammation. It is diagnosed when at least two of the following signs are present:
SIRS is a warning sign that the body is under serious stress and can lead to complications like organ failure if not treated promptly.
The Glasgow Coma Scale is a tool used by doctors to measure a person’s level of consciousness. It helps assess brain function after an injury or during a serious illness. The score is based on three types of responses:
The scores are added up to give a total between 3 and 15. A score of 15 means the person is fully alert, while a score below 15 can indicate confusion or impaired brain function.
Pleural effusion is the build-up of fluid in the space between the lungs and the chest wall. This space is called the pleural cavity. Normally, a small amount of fluid is present to help the lungs move smoothly during breathing. However, in some conditions like acute pancreatitis, fluid can accumulate and cause symptoms such as:
Pleural effusion is usually detected through medical imaging like a chest X-ray or CT scan. Its presence in a patient with acute pancreatitis can be a sign of a more severe case.
The BISAP score is used to assess the severity of acute pancreatitis and predict patient outcomes.
The BISAP score consists of five components: blood urea nitrogen (BUN) level, impaired mental status, systemic inflammatory response syndrome (SIRS), age > 60 years, and pleural effusion. Each factor scores 1 point if present.
A high BISAP score (4-5) indicates a higher risk of severe complications and mortality in acute pancreatitis patients.
The BISAP score is primarily designed for early severity prediction within the first 24 hours of hospital admission.
No, other scoring systems like Ranson's criteria, APACHE II, and CT severity index are also used in clinical practice.
The Bedside Index for Severity in Acute Pancreatitis (BISAP) Score Calculator is provided for educational and informational purposes only. It is not intended to serve as a diagnostic tool or to replace clinical judgment. The calculator is designed to assist healthcare professionals in estimating the severity of acute pancreatitis within the first 24 hours of hospital admission, but it must be used as part of a comprehensive clinical evaluation.
The BISAP score does not account for all clinical factors that may influence a patient’s condition, such as local complications, individual comorbidities, imaging findings, or the patient's response to treatment. It is intended to supplement—not substitute—clinical decision-making.
This calculator should only be used by qualified healthcare professionals with the appropriate training to interpret the results in the context of each individual patient. Non-professional users should not attempt to use this tool to evaluate or manage medical conditions.
If you or someone you know is experiencing symptoms of acute pancreatitis, seek immediate medical attention. Do not rely on online tools for diagnosis or treatment without consulting a licensed medical provider.
By using this calculator, you acknowledge and accept that the developers and publishers are not responsible for any decisions made or actions taken based on its results.