Risk score to predict inpatient mortality of acute pancreatitis patients admitted to the intensive care unit.

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pancreatology Pub Date : 2024-10-22 DOI:10.1016/j.pan.2024.10.010

Hassam Ali, Vishali Moond, Fnu Vikash, Dushyant Singh Dahiya, Manesh Kumar Gangwani, Amir Humza Sohail, Amy Chang, Jinye Liu, Umar Hayat, Pratik Patel, Mohamed Khalaf, Douglas G Adler

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Abstract

Background/objectives: Predicting inpatient mortality for acute pancreatitis (AP) patients in the ICU is crucial for optimal treatment planning. This study aims to develop a concise risk score model for this purpose, enhancing the predictability and management of AP in ICU settings.

Methods: We included 380 patients in our training set. Twenty-seven variables were retrospectively collected, and predictive variables were selected using LASSO penalized regression and refined through backward elimination multivariate models. Effect sizes were used to create the final model to predict 7 and 30-day mortality among AP patients admitted to the ICU.

Results: Of 380 patients, the mortality rate was 23.2 %. The final model included five predictors: INR, Albumin, Lactic Acid, BUN, and Bilirubin. The 5-fold cross-validated mean AUC was 0.93 (SD: 0.048) for 7-day mortality and 0.84 (SD: 0.033) for 30-day mortality, with a sensitivity of 77 % and specificity of 74 %. The risk score outperformed BISAP (AUC: 0.60) and APACHE-II (AUC: 0.76) in predicting mortality.

Conclusion: Our model offers a convenient tool using commonly available laboratory results to predict mortality among AP patients, with potential applicability in both ICU settings.

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预测入住重症监护室的急性胰腺炎患者住院死亡率的风险评分。

背景/目的：预测重症监护室急性胰腺炎（AP）患者的住院死亡率对于制定最佳治疗方案至关重要。本研究旨在为此开发一个简明的风险评分模型，以提高重症监护室中急性胰腺炎的可预测性和管理水平：方法：我们将 380 名患者纳入训练集。我们回顾性地收集了 27 个变量，使用 LASSO 惩罚回归法选出了预测变量，并通过反向消除多变量模型进行了改进。利用效应大小建立最终模型，预测入住重症监护室的 AP 患者 7 天和 30 天的死亡率：在 380 名患者中，死亡率为 23.2%。最终模型包括五个预测因子：INR、白蛋白、乳酸、尿素氮和胆红素。经 5 倍交叉验证，7 天死亡率的平均 AUC 为 0.93（标度：0.048），30 天死亡率的平均 AUC 为 0.84（标度：0.033），灵敏度为 77%，特异度为 74%。在预测死亡率方面，风险评分优于 BISAP（AUC：0.60）和 APACHE-II（AUC：0.76）：我们的模型提供了一种方便的工具，利用常见的实验室结果预测 AP 患者的死亡率，可能适用于两种 ICU 环境。

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.