Risk factors for acute pancreatitis complicated with sepsis in intensive care unit
10.3760/cma.j.issn.1671-0282.2024.10.008
- VernacularTitle:重症监护病房内急性胰腺炎并发脓毒症的风险
- Author:
Zhuangli LI
1
;
Yuedong LI
;
Jun YUAN
;
Zehua WU
;
Yun SUN
Author Information
1. 安徽医科大学第二附属医院重症医学一科，合肥 230601
- Keywords:
Intensive care unit;
Acute pancreatitis;
Sepsis;
Risk factor;
Predictive model
- From:
Chinese Journal of Emergency Medicine
2024;33(10):1390-1397
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the risk factors for sepsis with acute pancreatitis (AP) in the intensive care unit, Nomogram models were constructed and evaluatedand.Methods:Clinical data of 306 AP patients were admitted to the First Department of Critical Care Medicine. The Second Affiliated Hospital of Anhui Medical University from October 2013 to October 2023 were included, they were divided into sepsis group and non-sepsis group according to whether sepsis occurred. Baseline data and laboratory test results of the two groups were compared. The study subjects were randomly(random number) divided into training set and verification set, and the optimal variables were selected by LASSO regression. Then multivariate Logistic regression analysis was performed to construct a Nomogram risk prediction model. Then the prediction efficiency of the model was evaluated.Results:A total of 306 AP patients were included, including 127 patients with sepsis and 179 patients without sepsis. According to the ratio of 7:3, 215 cases were randomly (random number) divided into the training set and 91 cases were verified. Multivariate Logistic regression analysis showed that BMI, APACHEⅡ score, platelet, IL-6, total bilirubin and complications were independent risk factors for sepsis in patients with AP. According to the above risk factors, a Nomogram prediction model was established. The area under ROC curve of the model in training set and verified set were 0.913 (95% CI 0.875-0.951) and 0.901 (95% CI 0.837-0.965) respectively. The calibration curve shows that the predicted probability is basically consistent with the actual probability. Decision curve analysis shows that it has good clinical net benefit in a large threshold range. Conclusions:The independent risk factors of AP associated with sepsis in ICU are BMI, APACHEⅡscore, platelet, IL-6, total bilirubin and complications. The Nomogram risk predictive model based on these factors has good predictive power.
