BISAP Score Calculator for Pancreatitis
Predict mortality risk in acute pancreatitis within the first 24 hours using the BISAP score (Bedside Index of Severity in Acute Pancreatitis). Five findings — BUN, mental status, SIRS, age and pleural effusion — each add one point, for a total of 0 to 5. A score of 3 or more marks a substantially higher risk of severe disease and death. Tick those that apply.
About the BISAP score
BISAP is a simple bedside score that risk-stratifies acute pancreatitis within 24 hours of admission. Each of the five findings scores one point. Source: Wu BU et al., “The early prediction of mortality in acute pancreatitis: a large population-based study,” Gut 2008;57(12):1698–1703.
How this is calculated
| Factor | Points |
|---|---|
| BUN > 25 mg/dL | 1 |
| Impaired mental status (GCS < 15) | 1 |
| SIRS (≥ 2 of 4 criteria) | 1 |
| Age over 60 | 1 |
| Pleural effusion on imaging | 1 |
| Maximum | 5 |
Add one point for each finding present within 24 hours. Approximate in-hospital mortality: 0.1% (0), 0.5% (1), 1.9% (2), 5.3% (3), 12.7% (4), 22.5% (5); a score ≥ 3 marks higher risk. Source: Wu BU et al., Gut 2008;57(12):1698–1703.
Frequently asked questions
What are the five BISAP criteria?
Each of these scores one point, assessed within the first 24 hours: BUN over 25 mg/dL; Impaired mental status (a Glasgow Coma Scale under 15, or new disorientation); SIRS (two or more of temperature under 36 or over 38 °C, heart rate over 90, respiratory rate over 20 or PaCO₂ under 32, and white-cell count under 4 or over 12); Age over 60; and a Pleural effusion on imaging. The letters B-I-S-A-P are the mnemonic, and the total runs from 0 to 5. BISAP stands for Bedside Index for Severity in Acute Pancreatitis, and every item can be obtained from a routine admission work-up — blood tests, vital signs and a chest X-ray for the effusion — without further specialist testing.
What mortality does each BISAP score carry?
In the validation cohorts the in-hospital mortality rose steeply with the score: roughly 0.1% at 0, 0.5% at 1, 1.9% at 2, 5.3% at 3, 12.7% at 4 and 22.5% at 5. In practice a score under 3 is regarded as lower risk (mortality under about 2%) and 3 or more as higher risk. Local figures vary, so use the band rather than the exact percentage.
How does BISAP compare with Ranson and APACHE II?
BISAP was designed to be simpler than Ranson’s criteria (which need 48 hours) and APACHE II (many variables), while giving comparable early prediction of severe acute pancreatitis. Its main advantage is that all five items are available at the bedside within 24 hours of admission. It predicts risk; it does not, on its own, dictate management.
What counts as impaired mental status?
Any new alteration in mental state — disorientation, lethargy, drowsiness or a Glasgow Coma Scale below 15 — scores the point. It should be a change from the patient’s baseline, not a long-standing cognitive impairment, and reflects the encephalopathy that can accompany severe pancreatitis or its complications. Like the other four BISAP criteria, it is assessed once, within the first 24 hours of presentation, rather than tracked serially through the admission.
When should BISAP not be relied on?
BISAP estimates severity and mortality risk in acute pancreatitis; it is not a diagnosis and does not replace serial assessment, since a patient can deteriorate after a reassuring early score. It is validated in adults and should be combined with clinical judgement, imaging and trend of the illness. This is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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