Establishment of a nomogram for predicting the severity of the first-onset acute pancreatitis
10.3760/cma.j.issn.1674-1935.2019.06.006
- VernacularTitle: 预测首次发作急性胰腺炎病情严重程度列线图的建立
- Author:
Qing CHEN
1
;
Suhan LIN
1
;
Yueyue HUANG
2
;
Jingye PAN
2
Author Information
1. Department of Emergency, Wenzhou Central Hospital, Wenzhou 325000, China
2. Intensive Care Unit, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Publication Type:Journal Article
- Keywords:
Pancreatitis;
Nomograms;
Prognosis
- From:
Chinese Journal of Pancreatology
2019;19(6):420-424
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a visualized nomogram with early predictive value for the severity of first-onset acute pancreatitis (AP).
Methods:706 cases of first-onset AP patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 72 hours from January 2013 to January 2016 were collected. According to the revised Atlanta classification of AP in 2012, AP patients was divided into non-severe pancreatitis (NSAP, also called mild acute pancreatitis and moderately severe acute pancreatitis) group and severe acute pancreatitis (SAP) group. The demographic data (age, body mass index and admission time, etc) and laboratory tests (serum amylase, blood sugar, albumin, white blood cells, creatinine, urea nitrogen) were collected and statistically analyzed. Logistic univariate and multivariant regression analysis were performed based on the relevant clinical indicators. The statistically significant indicators were used to obtain regression equations. The R-language software was used to obtain the visualized nomogram via LR model, which was further validated by ROC curve analysis.
Results:In univariate logistic regression analysis, the OR (95% CI) values of blood glucose, creatinine at admission and 24 h after admission, urea nitrogen at admission and 24 h after admission, white blood cell, albumin in NSAP group and SAP group were 1.132(1.080-1.186), 1.019(1.013-1.025), 1.026(1.020-1.033), 1.066(1.035-1.099), 1.333(1.241-1.432), 1.083(1.032-1.136), and 0.853(0.811-0.889), and all the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that the regression equation of the LR model was Y=-2.657-0.116×albumin(g/L)+ 0.082×white blood cell(×109/L)+ 0.118× glycemia(mmol/L)+ 0.022× 24 h after admission creatinine (μmol/L). A total score of more than 60 points on the nomogram predicted the possibility of SAP. If the total score exceeded 130, the possibility of SAP may be up to 14% or more. Furthermore, the ROC curve analysis confirmed that the sensitivity and specificity of LR model established in this study for predicting of SAP were superior to those of urea nitrogen, creatinine and BISAP score alone by AUC, respectively.
Conclusions:This nomogram may be a useful clinical tool for predicting the severity of the first-onset acute pancreatitis.
