Background: Acute pancreatitis is defined as an inflammatory process of the pancreas with possible peri pancreatic tissue and multi-organ involvement inducing Multi-Organ Dysfunction Syndrome (MODS) with an increased mortality rate.The underlying mechanism of injury in pancreatitis is thought to be premature activation of pancreatic enzymes within the pancreas, leading to a process of auto digestion. Due to the risk of rapid deterioration in severe acute pancreatitis, the assessment of severity becomes crucial to a clinician. Multiple risk stratification tools for acute pancreatitis have been developed, but their clinical usefulness is limited. In Ranson's criteria and modified Glasgow score there are multiple parameters, of which some of them are not available in majority of hospitals in India. In addition, both are assessed after 48hrs, thereby missing potentially valuable early therapeutic window. The APACHE II score (Acute Physiology and Chronic Health Evaluation) is the most widely used prediction system currently, but it requires the collection of large number of parameters some of which may not be relevant to prognosis. APACHE II was originally developed as an intensive care instrument. For this purpose, a simple and accurate clinical scoring system that is, Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system was developed. This scoring system is used for stratifying patients according to their risk of mortality and is able to identify patientsat increased risk of mortality prior to the onset of organ failure. More over the data for BISAP score is collected within the first 24hrs of hospitalization. The ability tostratify
patients early in their course is a major step in improving future management strategies in acute pancreatitis.
Methods:
A prospective study was done in cases of acute pancreatitis with the effectiveness of Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system is used for stratifying patients according to their risk of mortality and is able to identify patients at increased risk of mortality prior to the onset of organ failure
Results:
A total of 50 cases were taken and the Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system was calculated in assessing mortality and intermediate markers of severity in acute pancreatitis in 24 hours of presentation. It is observed that individuals with BISAP score ≥3 were 4.5 times more likely to develop organ failure and 6 times more likely to develop pancreatic necrosis, than those with BISAP score
Key words: Acute pancreatitis; Ransons score; Glasgow score; BISAP
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