A prospective study of the bedside index for severity in acute pancreatitis (BISAP) score in predicting severity and prognosis of acute pancreatitis

Abstract

Acute pancreatitis is an inflammation of the pancreas with possible peripancreatic tissue involvement and multiorgan involvement. It results from a complex process that has variable etiology and natural histories, and early identification of patients at high risk can be difficult. Most episodes of acute pancreatitis (80%) are mild and self-limiting without sequelae. In 10-20% of cases, however, severe disease develops and parts of the pancreas and surrounding tissue become necrotic. In such cases, the acute inflammatory response may progress to systemic inflammatory response syndrome and/or multiorgan failure resulting in death. Identification of patients at risk for mortality early in the course of acute pancreatitis is an important step in improving outcome. The management of acute pancreatitis is still a challenge facing the clinician. Various strategies have been used to predict the severity and outcome of acute pancreatitis, including the Ranson’s criteria, Acute Physiology and Chronic Health Evaluation (APACHE) II, Computed Tomography Severity Index (CTSI), Glasgow scoring systems. Each has advantages and disadvantages, and none is currently recognized as a criterion standard.