Usefulness of the Bedside Index for Severity in Acute Pancreatitis in the Early Prediction of Severity and Mortality in Acute Pancreatitis

Objectives: The aim of this study was to evaluate the usefulness of the Bedside Index for Severity in Acute Pancreatitis (BISAP) in the early prediction of severity and mortality in AP. Methods: The medical records of all patients with acute pancreatitis (AP) admitted to our institution between January 2008 and July 2010 were reviewed retrospectively. Severe AP was defined as the persistence of organ failure for more than 48 hours. The capacity of the BISAP score to predict severity and death was evaluated using linear-by-linear association. The predictive accuracy of the BISAP and Ranson score was measured as the area under the receiver operating characteristic curve (AUC). Results: Of 299 consecutive patients, 22 (7.4%) were classified as having severe AP, and 8 (2.7%) died. There were statistically significant trends for increasing severity (P < 0.001) and mortality (P < 0.001) with increasing BISAP. The AUC for severity predicted by BISAP was 0.762 (95% confidence interval, 0.631-0.893) and by Ranson score was 0.804 (0.717-0.892). The AUC for mortality predicted by BISAP was 0.940 ( 0.863-1.018) and by Ranson score was 0.861 (0.734-0.988). Conclusions: We confirmed that BISAP is an accurate means of risk stratification in AP within 24 hours of presentation.