Diagnostic Accuracy and Inter-Score Agreement Between BISAP and Ranson's Scoring Systems in Predicting Severity of Acute Pancreatitis: A Cross-Sectional Study

Background: Early prediction of severity in acute pancreatitis (AP) is essential for timely intervention and resource allocation. The Ranson scoring system is widely used but requires 48-hour data, whereas the BISAP score offers a simplified and earlier alternative. Objective: To compare the diagnostic accuracy and inter-score agreement between BISAP and Ranson scoring systems in predicting the severity of acute pancreatitis. Methods: A prospective observational study was conducted over two years on 50 patients with acute pancreatitis at a tertiary care hospital. Severity was classified using both BISAP (within 24 hours) and Ranson (over 48 hours) scores. Outcomes including ICU admission, length of hospital stay, and mortality were recorded. Sensitivity, specificity, predictive values, and agreement between scores were analyzed using standard statistical methods. Results: Out of 50 patients, Ranson score identified 8 (16%) as having severe AP, while BISAP identified 7 (14%) as severe. The sensitivity and specificity of BISAP in comparison to Ranson were 87.5% and 100%, respectively. The positive predictive value was 100%, and the negative predictive value was 97.67%. BISAP showed strong agreement with Ranson scoring in severity classification. Conclusion: BISAP is a simple, early, and reliable tool for predicting severity in acute pancreatitis. Its comparable accuracy to Ranson scoring, combined with ease of bedside application, supports its use as a practical alternative for early triage and risk stratification in emergency and resource-constrained settings.