Evaluation of the Accuracy of the BISAP Scoring System in Predicting the Severity of Acute Pancreatitis: A Study of Saraburi Hospital
Keywords:
Acute pancreatitis, BISAP score, Severity, Severity predictionAbstract
Early risk assessment in acute pancreatitis (AP) is crucial. While the BISAP score is a simplified tool, its performance varies across clinical contexts. This retrospective analytical study aimed to evaluate the BISAP score’s predictive ability for AP severity. The research analyzed 254 patients (aged ≥18) diagnosed per the 2012 Revised Atlanta Classification between 2020 and 2024, utilizing a cut-off score of ≥3.
The results revealed that the majority of the patients were male (76%) with a mean age of 50.39 ± 16.30 years. Alcohol was the primary etiology (51.2%). Severity was classified as mild 70.1% of patients, moderate in 15.7%, and severe in 14.2%. The mortality rate was 7.9%, with a mean hospital stay of 6.17 ± 9.03 days. Using a BISAP cut-off of ≥3, the score demonstrated 58.3% sensitivity, 91.3% specificity, 52.5% PPV, 93.0% NPV, and 88.6% accuracy. The AUC was 0.748 (95% CI: 0.64–0.84; p < 0.001), indicating moderate-to-good predictive performance.
In conclusion, the BISAP score is effective for predicting severity in acute pancreatitis, offering high specificity and NPV. It is particularly useful for early identification of low-risk patients. However, its moderate sensitivity necessitates its use alongside other clinical indicators to ensure accurate detection of high-risk patients and to optimize management.
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Iannuzzi JP, King JA, Leong JH, Aragnouit J, Stanwell J, Forbes N, et al. Global Incidence of Acute Pancreatitis Is Increasing Over Time: A Systematic Review and Meta-Analysis. Gastroenterology. 2022;162(1):122-34. https://doi.org/10.1053/j.gastro.2021.09.043
Boxhoorn L, Voermans RP, Bouwense SA, Bruno MJ, Verdonk RC, Boermeester MA, et al. Acute pancreatitis. Lancet. 2020;396(10252):726-34. https://doi.org/10.1016/S0140-6736(20)31310-6
Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3):175-84. https://doi.org/10.1038/s41575-018-0087-5
Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4 Suppl 2):e1-15. https://doi.org/10.1016/j.pan.2013.07.063
Sternby H, Bolado F, Canaval-Zuleta HJ, Tapia L, Kylanpaa L, Kohoutova D, et al. Determinants of Severe Acute Pancreatitis: A European Multicenter Study. United European Gastroenterol J. 2019;7(2):191-200.
Mounzer R, Langmead CJ, Wu BU, Mederos R, Vicente W, Bryant R, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology. 2012;142(7):1476-82. https://doi.org/10.1053/j.gastro.2012.03.005
Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. https://doi.org/10.1136/gutjnl-2012-302779
Sarr MG. 2012 revision of the Atlanta classification of acute pancreatitis. Pol Arch Med Wewn. 2013;123(1-2):57-60. https://doi.org/10.20452/pamw.1627
Shafiq F, Shafiq A, Zafar S, Khan Z, Ali S, Abbas S, et al. Quality of care and outcomes of patients with acute pancreatitis in intensive care unit. J Ayub Med Coll Abbottabad. 2017;29(4):552-56.
Tenner S, Baillie J, DeWitt J, Vege SS, American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400-15. https://doi.org/10.1038/ajg.2013.218
Pongprasobchai S, Choakpichitchai B, Pannasiri C, Jesadapatrakul S, Pausawasdi N, Leelakusolvong S, et al. Comparison of various scoring systems in predicting the severity of acute pancreatitis in Thailand. J Gastroenterol Hepatol. 2013;28(Suppl 3):1-10.
Vannasiri C, Pongprasobchai S. Etiology and outcomes of acute pancreatitis in a Thai tertiary care hospital. Siriraj Med J. 2018;70(4):315-20.
Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA, et al. The early prediction of mortality in acute pancreatitis: a large predictive model based on data from 17,992 cases. Gut. 2008;57(12):1698-703. https://doi.org/10.1136/gut.2008.152702
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 of acute pancreatitis. Am J Gastroenterol. 2010;105(2):435-41. https://doi.org/10.1038/ajg.2009.622
Arif A, Shafiq F, Haider K, Ghafoor S, Ali S, Hussain S, et al. Comparison of Ranson's Criteria and BISAP Score in Predicting Severity of Acute Pancreatitis. Cureus. 2019;11(10):e5893.
Chen L, Lu G, Zhou Q, Zhan Q. Evaluation of the BISAP score in predicting severity and prognosis of acute pancreatitis. Exp Ther Med. 2013;5(1):283-86. https://doi.org/10.9738/0020-8868-98.1.6
Gao W, Yang HX, Ma CE. The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis. PLoS One. 2015;10 (6):e0130412. https://doi.org/10.1371/journal.pone.0130412
Yang YX, Li L. Validation of BISAP score for predicting severity and mortality in acute pancreatitis: a systematic review and meta-analysis. Int J Surg. 2016;30:112-23.
Chaosawat O. Comparative Evaluation of Harmless Acute Pancreatitis Score (HAPS) and Bedside Index of Severity in Acute Pancreatitis (BISAP) Scoring System in the Stratification of Prognosis in Acute Pancreatitis at Fang Hospital Chiang Mai. J Phrae Public Health Dev. 2025;5(2) :1-13.
Kiatvipanavi K, Boonmee C. Clinical characteristics and factors predicting severe acute pancreatitis: A 5-year retrospective study. J Med Assoc Thai. 2020;103(12) :1245-51.
Khanna AK, Tiwary SK, Kumar P, et al. Comparison of APACHE II, BISAP, and Ranson Scores in the Prediction of Severity of Acute Pancreatitis. HPB Surg. 2013;2013:809168. https://doi.org/10.1155/2013/367581
Yadav J, Sharma N, Chaudhary S, Kumar J, Soni N, Singh P, et al. Prediction of severity and outcome of acute pancreatitis using BISAP score. J Clin Diagn Res. 2015;9 (2):PC10-14.
Vásquez-Garcés EA, Beitia-Quintero N, Rojas-Serna S, Méndez-Sánchez L, López-López R, García-García A, et al. Accuracy of the BISAP score in predicting the severity of acute pancreatitis. Rev Gastroenterol Mex (Engl Ed). 2020;85(4):421-27.
Jain S, Mohapatra MK, Jain S, Gupta S, Gupta R, Jain K, et al. Comparison of Various Scoring Systems in Predicting the Severity of Acute Pancreatitis. Indian J Surg. 2015;77(S3):1387-91.
Harshit Kumar A, Singh Griwan M. A Comparison of APACHE II, BISAP, and Ranson's Scoring Systems. Cureus. 2018;10(9):e3251.
Cho JH, Kim TN, Chung HH, Kim KH. Comparison of scoring systems in predicting the severity of acute pancreatitis. World J Gastroenterol. 2015;21(8):2387-94. https://doi.org/10.3748/wjg.v21.i8.2387
Zhang J, Shahbaz S, Fang R, Liang B, Liu J, Wang B, et al. External validation of the BISAP score: A systematic review and meta-analysis. BMC Gastroenterol. 2022;22 (1):103. https://doi.org/10.1186/s12876-022-02132-0
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