BISAP score for acute pancreatitis

BISAP (Bedside Index for Severity in Acute Pancreatitis) uses five findings from the first 24 hours to identify patients at higher risk of death.

What goes into the BISAP score

BUN > 25 mg/dL (+1)
Impaired mental status (GCS < 15) (+1)
SIRS (≥ 2 criteria) (+1)
Age > 60 (+1)
Pleural effusion on imaging (+1)

How to interpret the result

0–2: lower risk (mortality < 2%)
3–5: higher risk (mortality about 5–20%)

Clinical pearls

Severity is defined by persistent organ failure > 48 hours (revised Atlanta), not by any single score.
WATERFALL (2022): moderate goal-directed fluids were safer than aggressive resuscitation.
Start early oral feeding as tolerated.

Evidence

Wu BU, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698-1703.

Related workups

Acute pancreatitis Acute abdominal pain

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For education only. Check the inputs and the population the score was validated in before acting on it. Not a substitute for clinical judgment.