For healthcare professionals
BISAP score calculator (acute pancreatitis)
The Bedside Index for Severity in Acute Pancreatitis (BISAP) scores 5 items from the first 24 hours of the hospital stay, 1 point each, for a total from 0 to 5. This calculator gives the total and whether it reaches 3, the cut point used for a high risk of severe disease and in-hospital mortality. It is written for clinicians and is not a diagnosis.
BISAP items (first 24 hours)
For an adult with acute pancreatitis, using values from the first 24 hours after presentation. Nothing you enter leaves this page.
What you will see
The BISAP score out of 5, the items that scored, and whether the total reaches 3, the cut point used for a high risk of severe disease and in-hospital mortality.
Educational only, not medical advice. Not a diagnosis and not a treatment decision.
Source
Wu BU and colleagues, Gut 2008 (derivation and validation). Items, the SIRS definition and the cut point of 3 as stated by Chen and colleagues, 2026, and in Table 6 of Lee and Cho, 2022 (both open access). The tests check every item, the SIRS rule and the cut point.
Validated in
Derived from 17,992 cases of acute pancreatitis at 212 US hospitals (2000 to 2001) and validated in 18,256 cases at 177 hospitals (2004 to 2005) (Wu 2008). Tested prospectively in 397 consecutive cases at one tertiary center (Singh 2009).
Limits
Built to predict in-hospital mortality, so few patients reach the top scores. Uses only data from the first 24 hours and can change as the illness evolves. Imaging for pleural effusion is not always done in the first day. It predicts risk; it does not diagnose pancreatitis or its cause.
BISAP items
Each item present in the first 24 hours scores 1 point, for a total from 0 to 5 (Wu 2008) (Lee and Cho 2022). The definitions and units below are as stated in an open-access 2026 cohort study (Chen 2026).
| Item | Scores 1 point when |
|---|---|
| BUN | Over 25 mg/dL (over 7.14 mmol/L) |
| Impaired mental status | Glasgow Coma Scale under 15 |
| SIRS | 2 or more of: temperature over 38 °C or under 36 °C; heart rate over 90 per minute; respiratory rate over 20 per minute or PaCO₂ under 32 mmHg; white cell count over 12,000 or under 4,000 per mm³ |
| Age | Over 60 years |
| Pleural effusion | Detected on imaging |
One review table also counts more than 10% immature band forms under the white cell criterion (Lee and Cho 2022). The calculator follows the four SIRS criteria as listed above; tick the white cell box if bands exceed 10%.
Reading the total
A score of 3 or more indicates a high risk of severe disease and in-hospital mortality (Chen 2026). In the derivation study, in-hospital mortality ranged from under 1% in the lowest risk group to over 20% in the highest, and in the validation cohort the area under the curve was 0.82, close to APACHE II at 0.83 (Wu 2008). In a prospective cohort of 397 cases, mortality rose with each point, and a score of 3 or more was linked to an odds ratio of 7.4 for organ failure, 12.7 for persistent organ failure and 3.8 for pancreatic necrosis (Singh 2009). A 2022 review suggests BISAP for the first assessment of patients with acute pancreatitis, with other scores as supplements (Lee and Cho 2022).
BISAP and Ranson
BISAP uses 5 items available on the first day. The Ranson criteria calculator counts 11 signs, 6 of which need the first 48 hours. Both use 3 points as the cut point for predicted severe disease (Chen 2026).
Related tools
For other clinician scores on this site, see the Ranson criteria calculator for acute pancreatitis, the SOFA score calculator for organ dysfunction, the qSOFA score calculator and the Glasgow Coma Scale calculator for mental status.
Sources
- Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57(12):1698-1703. doi:10.1136/gut.2008.152702. PMID 18519429. Abstract (derivation on 17,992 cases from 212 hospitals in 2000-2001, validation on 18,256 cases from 177 hospitals in 2004-2005, five items scored in the first 24 hours, mortality range and AUC 0.82 versus APACHE II 0.83). pubmed.ncbi.nlm.nih.gov/18519429/
- Singh VK, Wu BU, Bollen TL, 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(4):966-971. doi:10.1038/ajg.2009.28. PMID 19293787. Abstract (397 consecutive cases at one tertiary center, AUC 0.82 for mortality, odds ratios for organ failure, persistent organ failure and necrosis at a score of 3 or more). pubmed.ncbi.nlm.nih.gov/19293787/
- Chen Z, Liu MX, et al. Comparison of clinical characteristics and predictive performance of severity scoring systems in hypertriglyceridemic versus non-hypertriglyceridemic acute pancreatitis: a retrospective cohort study. Arch Endocrinol Metab. 2026;70(5):e260103. doi:10.20945/2359-4292-2026-0103. Open access (CC BY). Methods (Ranson criteria with SI units and the cut point of 3; BISAP items, SIRS definition and the cut point of 3). pmc.ncbi.nlm.nih.gov/articles/PMC13587624/
- Lee DW, Cho CM. Predicting severity of acute pancreatitis. Medicina (Kaunas). 2022;58(6):787. doi:10.3390/medicina58060787. Open access (CC BY). Section 5.1 and Table 4 (Ranson criteria, non-biliary and biliary), section 5.4 and Table 6 (BISAP), section 5.7 (comparison of scoring systems). pmc.ncbi.nlm.nih.gov/articles/PMC9227091/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-01. Spotted an error? See About.