Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Dig Liver Dis. 2022 Jun;54(6):805-811. doi: 10.1016/j.dld.2021.06.033. Epub 2021 Jul 23.
Persistent organ failure (POF) increases the risk of death in patients with acute biliary pancreatitis (ABP). Currently, there is no early risk assessment tool for POF in patients with ABP.
To establish and validate a dynamic nomogram for predicting the risk of POF in ABP.
This was a retrospective study of 792 patients with ABP, with 595 cases in the development group and 197 cases in the validation group. Least absolute shrinkage and selection operator regression screened the predictors of POF, and logistic regression established the model (P < 0.05). A dynamic nomogram showed the model. We evaluated the model's discrimination, calibration, and clinical effectiveness; used the bootstrap method for internal validation; and conducted external validation in the validation group.
Neutrophils, haematocrit, serum calcium, and blood urea nitrogen were predictors of POF in ABP. In the development group and validation group, the areas under the receiver operating characteristic curves (AUROCs) were 0.875 and 0.854, respectively, and the Hosmer-Lemeshow test (P > 0.05) and calibration curve showed good consistency between the actual and prediction probability. Decision curve analysis showed that the dynamic nomogram has excellent clinical value.
This dynamic nomogram helps with the early identification and screening of high-risk patients with POF in ABP.
持续性器官衰竭（POF）增加了急性胆源性胰腺炎（ABP）患者的死亡风险。目前，ABP 患者中尚无 POF 的早期风险评估工具。
建立和验证预测 ABP 患者 POF 风险的动态列线图。
这是一项回顾性研究，纳入了 792 例 ABP 患者，其中 595 例患者纳入开发组，197 例患者纳入验证组。最小绝对收缩和选择算子回归筛选出 POF 的预测因素，然后进行逻辑回归建立模型（P<0.05）。动态列线图显示了该模型。我们评估了模型的判别能力、校准能力和临床效果；使用 bootstrap 方法进行内部验证，并在验证组中进行外部验证。
中性粒细胞、红细胞压积、血清钙和血尿素氮是 ABP 中 POF 的预测因素。在开发组和验证组中，受试者工作特征曲线（AUROCs）下面积分别为 0.875 和 0.854，Hosmer-Lemeshow 检验（P>0.05）和校准曲线显示实际概率与预测概率之间具有良好的一致性。决策曲线分析表明，该动态列线图具有出色的临床价值。
该动态列线图有助于早期识别和筛选 ABP 中 POF 的高危患者。
