1.Development and validation of a risk prediction model for severe acute pancreatitis induced by hypertriglyceridemia
Zhe WANG ; Hanzhang DENG ; Kaixin PENG ; Jiongdi LU ; Liang ZHANG ; Xiaolei SHI ; Yunpeng PENG ; Kedong XU ; Zheng WANG ; Guotao LU ; Gang WANG ; Zipeng LU ; Fei LI ; Li WEN ; Feng CAO
Chinese Journal of Surgery 2025;63(8):720-726
Objective:To investigate the risk factors for patients with hypertriglyceridemia-related acute pancreatitis (HTG-AP) developing into severe acute pancreatitis or experiencing organ failure.Methods:This retrospective cohort study collected clinical data from 2 429 patients diagnosed with acute pancreatitis from five hospitals in China between January 2019 and December 2023 using a pre-designed data collection form. The cohort included 1 516 males and 913 females,with an age of (50.2±16.5)years(range: 11 to 99 years). Among them,353 patients (16.1%) had HTG-AP,while 1 846 (83.9%) had non-HTG-AP. HTG-AP was defined as serum triglyceride levels>500 mg/dl with other etiologies excluded. Intergroup comparisons were performed using t-tests,Mann-Whitney U test or χ2 tests,respectively. Univariate and multivariate logistic regression analyses were conducted to assess risk factors for severe acute pancreatitis after adjusting for potential confounders,and a predictive model was developed and validated. Results:Compared with other etiologies,HTG-AP patients had a higher risk of progressing to SAP ( OR=1.415,95% CI: 0.866 to 2.312, P=0.017) and organ failure ( OR=1.256,95% CI: 1.015 to 1.554, P=0.036). Among HTG-AP patients,risk factors for SAP included body mass index ( OR=1.856,95% CI: 1.742 to 1.987, P=0.033),fasting blood glucose ( OR=1.128,95% CI: 1.036 to 1.229, P=0.006),white blood cell count( OR=1.162,95% CI: 1.055 to 1.281, P=0.002),and the presence of pleural effusion ( OR=13.151,95% CI: 4.330 to 19.946, P<0.01). A nomogram prediction model for SAP in HTG-AP was constructed based on these risk factors,demonstrating good discriminative ability with area under the curve values of 0.877 in the training set and 0.894 in the validation set,along with satisfactory calibration. Conclusions:HTG-AP patients are at higher risk of developing SAP and organ failure. The risk prediction model incorporating body mass index,fasting blood glucose,white blood cell count,and pleural effusion shows good predictive value for SAP.
2.Development and validation of a risk prediction model for severe acute pancreatitis induced by hypertriglyceridemia
Zhe WANG ; Hanzhang DENG ; Kaixin PENG ; Jiongdi LU ; Liang ZHANG ; Xiaolei SHI ; Yunpeng PENG ; Kedong XU ; Zheng WANG ; Guotao LU ; Gang WANG ; Zipeng LU ; Fei LI ; Li WEN ; Feng CAO
Chinese Journal of Surgery 2025;63(8):720-726
Objective:To investigate the risk factors for patients with hypertriglyceridemia-related acute pancreatitis (HTG-AP) developing into severe acute pancreatitis or experiencing organ failure.Methods:This retrospective cohort study collected clinical data from 2 429 patients diagnosed with acute pancreatitis from five hospitals in China between January 2019 and December 2023 using a pre-designed data collection form. The cohort included 1 516 males and 913 females,with an age of (50.2±16.5)years(range: 11 to 99 years). Among them,353 patients (16.1%) had HTG-AP,while 1 846 (83.9%) had non-HTG-AP. HTG-AP was defined as serum triglyceride levels>500 mg/dl with other etiologies excluded. Intergroup comparisons were performed using t-tests,Mann-Whitney U test or χ2 tests,respectively. Univariate and multivariate logistic regression analyses were conducted to assess risk factors for severe acute pancreatitis after adjusting for potential confounders,and a predictive model was developed and validated. Results:Compared with other etiologies,HTG-AP patients had a higher risk of progressing to SAP ( OR=1.415,95% CI: 0.866 to 2.312, P=0.017) and organ failure ( OR=1.256,95% CI: 1.015 to 1.554, P=0.036). Among HTG-AP patients,risk factors for SAP included body mass index ( OR=1.856,95% CI: 1.742 to 1.987, P=0.033),fasting blood glucose ( OR=1.128,95% CI: 1.036 to 1.229, P=0.006),white blood cell count( OR=1.162,95% CI: 1.055 to 1.281, P=0.002),and the presence of pleural effusion ( OR=13.151,95% CI: 4.330 to 19.946, P<0.01). A nomogram prediction model for SAP in HTG-AP was constructed based on these risk factors,demonstrating good discriminative ability with area under the curve values of 0.877 in the training set and 0.894 in the validation set,along with satisfactory calibration. Conclusions:HTG-AP patients are at higher risk of developing SAP and organ failure. The risk prediction model incorporating body mass index,fasting blood glucose,white blood cell count,and pleural effusion shows good predictive value for SAP.
3.Speckle tracking imaging in evaluation on degree of coronary artery stenosis in patients with coronary artery disease
Ling PENG ; Fang ZHU ; Zhongxin DENG ; Mingyan DING ; Hanzhang ZHAO ; Wei JI ; Huihui ZHANG ; Lijuan GUO ; Ying LI
Chinese Journal of Medical Imaging Technology 2018;34(3):354-357
Objective To observe the value of speckle-tracking imaging (STI) in evaluation on degree of coronary artery stenosis in patients with coronary artery disease (CAD).Methods Totally 74 CAD patients,including 59 with coronary artery stenosis (coronary artery stenosis group) and 15 without coronary artery stenosis (no coronary artery stenosis group) underwent STI and echocardiography.Based on Gensini scores,the patients in coronary artery stenosis group were further divided into mild,moderate and severe subgroups.The average global longitudinal strain (GLS-Avg),basement global longitudinal strain (GLS-Bas),middle global longitudinal strain (GLS-Mid) and apical global longitudinal strain (GLS-AP) value were measured and compared.Results GLS-Avg,GLS-Bas,GLS-Mid and GLS-AP value in coronary artery stenosis group were lower than those in no coronary artery stenosis group (all P < 0.001).In coronary artery stenosis group,with the increase of stenosis severity,GLS-Avg,GLS-Bas,GLS-Mid and GLS-AP value decreased,and statistical differences were found between each two subgroups (all P<0.05).In coronary artery stenosis group,there were positive correlations between GLS-Avg,GLS-Bas,GLS-Mid,GLS-AP value and Gensini scores (r=0.861,0.847,0.819 and 0.778,all P< 0.05).Conclusion GLS value of STI can reflect the severity of coronary artery stenosis in CAD patients.

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