BISAP Score

BISAP Score — Acute Pancreatitis

5-variable severity score for acute pancreatitis (AUC 0.82). Assessed within 24h of admission — no 48h wait required. Score ≥ 3 = ICU-level care.

Within 24 Hours of Presentation

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Rapid bedside risk stratification of patients with acute pancreatitis (within first 24 hours)

To predict in-hospital mortality and severe acute pancreatitis (SAP)

Early triage to identify patients requiring aggressive fluid resuscitation or ICU monitoring

To provide prognostic information to family and multidisciplinary teams early in the admission

Patient Population

Adults with acute pancreatitis. Validated in multiple large-scale observational studies and compared head-to-head with Ranson and APACHE II.

When to Use APACHE II or Marshall Instead

Beyond 24 hours — the score is primarily a "snapshot" early predictor; persistent organ failure (Marshall/SOFA) is better for monitoring progress

Predicting infected necrosis — BISAP is better at predicting mortality than local complications

ICU research trials — APACHE II remains the standard for rigorous study matching

How it Works

The BISAP Acronym (5 Points)

B (BUN): > 25 mg/dL (8.9 mmol/L). Reflects under-resuscitation or renal compromise.

I (Impaired Mental Status): Disorientation, lethargy, or GCS < 15.

S (SIRS): Presence of 2 or more SIRS criteria (Temp, HR, RR, WBC).

A (Age): > 60 years.

P (Pleural Effusion): Identified within the first 24 hours (via chest X-ray, ultrasound, or CT).

Mortality Risk Stratification

0–2 Points	Low Risk (< 2% mortality)
3 Points	Moderate Risk (~5–8% mortality)
4 Points	High Risk (~12–15% mortality)
5 Points	Very High Risk (> 22% mortality)

Last Comprehensive Review: 2026-07-17

Related Tools

M-ANNHEIM Classification

Modified CT Severity Index

SOFA Score

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BISAP Score

BISAP Score — Acute Pancreatitis

When to Use

When to Use

Patient Population

When to Use APACHE II or Marshall Instead

How it Works

The BISAP Acronym (5 Points)

Mortality Risk Stratification

Clinical Pearls

Simplicity vs. Accuracy

The Importance of SIRS

Clinical Pearls

Next Steps

Management Action

The Evidence

Original Derivation

The early prediction of mortality in acute pancreatitis: a large-cost-effective prognostic tool (BISAP).

Comparative Validation

Comparison of BISAP with Ranson's, APACHE-II, and CTSI in predicting mortality.

Origins & History

Bedside Index Philosophy

Related Tools

Recent Journal Updates

BISAP Score

BISAP Score — Acute Pancreatitis

When to Use

When to Use

Patient Population

When to Use APACHE II or Marshall Instead

How it Works

The BISAP Acronym (5 Points)

Mortality Risk Stratification

Clinical Pearls

Simplicity vs. Accuracy

The Importance of SIRS

Clinical Pearls

Next Steps

Management Action

The Evidence

Original Derivation

The early prediction of mortality in acute pancreatitis: a large-cost-effective prognostic tool (BISAP).

Comparative Validation

Comparison of BISAP with Ranson's, APACHE-II, and CTSI in predicting mortality.

Origins & History

Bedside Index Philosophy

Related Tools

Recent Journal Updates