Efficacy of BISAP score versus Ranson’s score to determine the severity index of acute pancreatitis
Keywords:Acute pancreatitis, BISAP score, Ranson’s score, BISAP versus Ranson’s, Severity index of acute pancreatitis
Background: Acute pancreatitis has widely variable clinical and systemic manifestations spanning the spectrum from a mild, self-limiting episode of epigastric pain to severe, life-threatening, multiorgan failure posing a significant therapeutic challenge for the health care providers. Bedside index of severity in acute pancreatitis (BISAP) is a scoring system that would precisely predict severity as early as within the first 24 hours of the course of acute pancreatitis. This study aims to compare BISAP and Ranson’s score to establish the validity of a simple and accurate clinical scoring system for stratifying patients.
Methods: All 84 cases admitted at HSK Hospital and SNMC, Bagalkot and diagnosed as acute pancreatitis were included in this study, from January 2019 to June 2020. Clinical evaluation in the form of detailed history, per abdominal, systemic examination and laboratory investigations, both BISAP and Ranson’s score were applied and compared, based upon data obtained at admission, within 24 hours and at 48 hours of hospitalization.
Results: Out of 84 cases with a male to female ratio of 16:1, majority belonged to age group 31-40 years (42%) and most common etiological factor being alcohol consumption (74%); 19% patients had severe acute pancreatitis and 68% patients had length of hospital stay less than a week. Major organ failure and pancreatic necrosis, severity of BISAP and Ranson’s score were found to be significantly correlated, (p<0.001); mortality was found to be 1.2%.
Conclusions: Compared to Ranson’s score, BISAP score is equally effective in finding out the frequency of severity and predicting mortality in patients with acute pancreatitis .The values in BISAP score are instantaneous with no time delay.
Yeo CJ. Shackelford’s surgery of the alimentary tract. 8th ed. Philadelphia, PA: Elsevier. 2019.
Shabbir S, Jamal S, Khaliq T, Khan ZM. Comparison of BISAP score with Ranson's score in determining the severity of acute pancreatitis. J Coll Physicians Surg Pak. 2015;25(5):328-1.
Imrie CW. Prognostic indicators in acute pancreatitis. Canad J Gastroenterol. 2003;17(5):325-8.
Wu BU, Johannes RS, Sun X. Early prediction of mortality in acute Pancreatitis: a large population-based study. Gut. 2008;57:1698-703.
Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.
Ranson JH, Rifkind KM, Roses DF. Objective early identification of severe acute pancreatitis. Am J Gastroenterol. 1974;61:443-51.
Papachristou GI, Muddana V, Yadav D, O'Connell M, Sanders MK, Slivka A, et al. Comparison of BISAP, Ranson's, APACHE-II and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105(2):435-41.
Singh V, Wu B, Bollen TL, Repas K, Maurer R, Johannes R, et al. A Prospective Evaluation of the Bedside Index for Severity in Acute Pancreatitis Score in Assessing Mortality and Intermediate Markers of Severity in Acute Pancreatitis. Am J Gastroenterol. 2009;104:966-971.
Bidarkundi GK, Wig JD, Bhatnagar A, Majumdar S. Clinical relevance of intracellular cytokines IL-6 and IL-12 in acute pancreatitis, and correlation with APACHE III score. Br J Biomed Sci. 2002;59(2):85-9.
Gullo L, Migliori M, Oláh A, Farkas G, Levy P, Arvanitakis C, Lankisch P, Beger H. Acute pancreatitis in five European countries: etiology and mortality. Pancreas. 2002;24(3):223-7.
Zheng Y, Zhou Z, Li H, Li J, Li A, Ma B, Zhang T, Liao Q, Ye Y, Zhang Z, Yang Y. A multicenter study on etiology of acute pancreatitis in Beijing during 5 years. Pancreas. 2015;44(3):409-14.
Singh H, Gougol A, Mounzer R, Yadav D, Koutroumpakis E, Slivka A, Whitcomb DC, Papachristou GI. Which patients with mild acute pancreatitis require prolonged hospitalization? Clin Translational Gastroenterol. 2017;8(12):129.
Petrov MS, Shanbhag S, Chakraborty M, Phillips AR, Windsor JA. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139(3):813-20.
Bung YK, Neeralagi CS, Suggaiah L, Rathnam U, Kesari C. A prospective study to predict the severity of acute pancreatitis by BISAP score. Int Surg J. 2017;4(7):2221-6..
Singh VK, Wu BU, Bollen TL, Repas K, Maurer R, Mortele KJ, Banks PA. Early systemic inflammatory response syndrome is associated with severe acute pancreatitis. Clin Gastroenterol Hepatol. 2009;7(11):1247-51.