The digestive department of The Second Affiliated Hospital of Soochow University, 215004, Suzhou, China.
The dental department of The Second Affiliated Hospital of Soochow University, 215004, Suzhou, China.
Pancreatology. 2024 Sep;24(6):863-869. doi: 10.1016/j.pan.2024.08.007. Epub 2024 Aug 16.
Pseudocyst formation is common in many patients with acute pancreatitis during follow-up. Many risk factors have been proposed to be associated with the development of PP, but the predictive factors are still underexplored. The focus of this study was to investigate whether early laboratory indicators could effectively predict the occurrence of PP.
2811 AP patients hospitalized in the Second Affiliated Hospital of Soochow University between November 2008 and September 2020 were retrospectively studied. Univariate and multivariate analyses were used to screen the risk variables. The nomograms of those risk factors were validated and evaluated by logistic analysis.
AP patients had a 6.1 % (172/2811) incidence of PP. In a univariate analysis, the development of PP was correlated with serum lactate dehydrogenase (LDH), albumin (ALB), calcium (Ca), hemoglobin (Hb), organ dysfunction, CT severity index (CTSI), etiology, age, etc. Further logistic regression analysis showed that the risk factors were different between hyperlipidemic pancreatitis patients (LDH, ALB and Ca) and non-hyperlipidemic pancreatitis patients (LDH, Hb, ALB and Ca). A nomogram based on the identified risk factors was developed. Our model showed good discrimination ability, with a boostrap - corrected C index of 0.905 (95 % CI = 0.875-0.935), and had well-fitted calibration curves. The area under the curve (AUC) of the nomogram were 0.905 (95 % CI = 0.875-0.935) and 0.933 (95 % CI = 0.890-0.975) in the training and validation groups, respectively. The results of DCA indicated that the nomogram may have clinic usefulness.
The nomogram that incorporates early laboratory data (LDH, Hb, ALB, and Ca) in AP patients is able to predict the incidence of PP with greater accuracy than the CTSI and AP severity.
假性囊肿在许多急性胰腺炎患者的随访中很常见。许多危险因素被认为与 PP 的发生有关，但预测因素仍未得到充分探索。本研究的重点是探讨早期实验室指标是否能有效地预测 PP 的发生。
回顾性分析 2008 年 11 月至 2020 年 9 月在苏州大学第二附属医院住院的 2811 例急性胰腺炎患者。采用单因素和多因素分析筛选危险因素。通过逻辑分析验证和评价这些危险因素的列线图。
急性胰腺炎患者中假性囊肿的发生率为 6.1%（172/2811）。单因素分析显示，PP 的发生与血清乳酸脱氢酶（LDH）、白蛋白（ALB）、钙（Ca）、血红蛋白（Hb）、器官功能障碍、CT 严重指数（CTSI）、病因、年龄等有关。进一步的逻辑回归分析表明，高脂血症性胰腺炎患者（LDH、ALB 和 Ca）和非高脂血症性胰腺炎患者（LDH、Hb、ALB 和 Ca）的危险因素不同。根据确定的危险因素建立了列线图。我们的模型具有良好的区分能力，bootstrap 校正 C 指数为 0.905（95%CI=0.875-0.935），校准曲线拟合良好。列线图在训练组和验证组的曲线下面积（AUC）分别为 0.905（95%CI=0.875-0.935）和 0.933（95%CI=0.890-0.975）。DCA 的结果表明，该列线图可能具有临床应用价值。
纳入急性胰腺炎患者早期实验室数据（LDH、Hb、ALB 和 Ca）的列线图能够更准确地预测 PP 的发生率，优于 CTSI 和急性胰腺炎严重程度。
