Department of Radiology, Children's Hospital of Soochow University, Suzhou, 215025, China.
Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, 215025, China.
Pediatr Surg Int. 2023 Mar 24;39(1):158. doi: 10.1007/s00383-023-05441-x.
This study aimed to develop a prediction model to identify risk factors for post-operative acute pancreatitis (POAP) in children with pancreaticobiliary maljunction (PBM) by pre-operative analysis of patient variables.
Logistic regression (LR), support vector machine (SVM), and extreme gradient boosting (XGBoost) models were established using the prospectively collected databases of patients with PBM undergoing surgery which was reviewed in the period comprised between August 2015 and August 2022, at the Children's Hospital of Soochow University. Primarily, the area beneath the receiver-operating curves (AUC), accuracy, sensitivity, and specificity were used to evaluate the model performance. The model was finally validated using the nomogram and clinical impact curve.
In total, 111 children with PBM met the inclusion criteria, and 21 children suffered POAP. In the validation dataset, LR models showed the highest performance. The risk nomogram and clinical effect curve demonstrated that the LR model was highly predictive.
The prediction model based on the LR with a nomogram could be used to predict the risk of POAP in patients with PBM. Protein plugs, age, white blood cell count, and common bile duct diameter were the most relevant contributing factors to the models.
本研究旨在通过术前分析患者变量,为胰胆管合流异常(PBM)儿童术后急性胰腺炎(POAP)的风险因素建立预测模型。
回顾性分析 2015 年 8 月至 2022 年 8 月期间在苏州大学附属儿童医院接受手术治疗的 PBM 患儿的前瞻性数据库,建立了逻辑回归(LR)、支持向量机(SVM)和极端梯度提升(XGBoost)模型。首先,使用受试者工作特征曲线下的面积(AUC)、准确性、敏感性和特异性来评估模型性能。最后,使用列线图和临床影响曲线对模型进行验证。
共纳入 111 例 PBM 患儿,其中 21 例发生 POAP。在验证数据集,LR 模型表现最佳。风险列线图和临床效应曲线表明,LR 模型具有较高的预测能力。
基于 LR 模型的列线图可用于预测 PBM 患者 POAP 的风险。蛋白栓、年龄、白细胞计数和胆总管直径是对模型最相关的影响因素。