• [Development and validation of...

Treffer: [Development and validation of a risk prediction model for severe acute pancreatitis induced by hypertriglyceridemia].

Title:
[Development and validation of a risk prediction model for severe acute pancreatitis induced by hypertriglyceridemia].
Authors:
Wang Z; Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China., Deng HZ; Center for Biomarker Discovery and Validation,National Infrastructures for Translation Medicine,Institute of Clinical Medicine,Peking Union Medical College Hospital,Beijing 100730,China., Peng KX; Center for Biomarker Discovery and Validation,National Infrastructures for Translation Medicine,Institute of Clinical Medicine,Peking Union Medical College Hospital,Beijing 100730,China., Lu JD; Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China., Zhang L; Department of Laparoscopic Surgery for Cancer,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China., Shi XL; Pancreatic Center,Department of Gastroenterology,the Affiliated Hospital of Yangzhou University,Yangzhou 225000, China., Peng YP; Pancreas Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 200029,China., Xu KD; Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China., Wang Z, Lu GT; Pancreatic Center,Department of Gastroenterology,the Affiliated Hospital of Yangzhou University,Yangzhou 225000, China., Wang G; Department of Laparoscopic Surgery for Cancer,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China., Lu ZP; Pancreas Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 200029,China., Li F; Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China., Wen L; Center for Biomarker Discovery and Validation,National Infrastructures for Translation Medicine,Institute of Clinical Medicine,Peking Union Medical College Hospital,Beijing 100730,China., Cao F; Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China.
Corporate Authors:
Chinese Hypertriglyceridemia-associated Pancreatitis Study Group
Source:
Zhonghua wai ke za zhi [Chinese journal of surgery] [Zhonghua Wai Ke Za Zhi] 2025 Aug 01; Vol. 63 (8), pp. 720-726.
Publication Type:
Comparative Study; English Abstract; Journal Article; Multicenter Study; Validation Study; English Abstract
Language:
Chinese
Journal Info:
Publisher: Zhonghua yi xue hui, Wai ke xue hui Country of Publication: China NLM ID: 0153611 Publication Model: Print Cited Medium: Print ISSN: 0529-5815 (Print) Linking ISSN: 05295815 NLM ISO Abbreviation: Zhonghua Wai Ke Za Zhi Subsets: MEDLINE
Imprint Name(s):
Original Publication: Beijing : Zhonghua yi xue hui, Wai ke xue hui
MeSH Terms:
Hypertriglyceridemia*/blood , Hypertriglyceridemia*/complications , Hypertriglyceridemia*/pathology , Pancreatitis*/diagnosis , Pancreatitis*/etiology , Risk Assessment*/methods , Risk Assessment*/standards , Predictive Learning Models*, Retrospective Studies ; Humans ; Male ; Female ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Risk Factors ; Triglycerides/blood ; Odds Ratio ; Blood Glucose/analysis ; Body Mass Index ; Blood Cell Count ; Nomograms ; Area Under Curve ; Multiple Organ Failure/diagnosis ; Multiple Organ Failure/etiology ; Predictive Value of Tests ; Logistic Models
Grant Information:
82122010, 82070659, 82470678 National Natural Science Foundation of China; 7242069 Beijing Natural Science Foundation; PX2023030 Beijing Hospital Administration Training Project; 2023-I2M-3-001 CAMS Innovation Fund for Medical Science; 2022-PUMCH-E-003 National High Level Hospital Clinical Research Funding; 82070659, 82122010, 82470678 National Natural Science Foundation of China
Contributed Indexing:
Local Abstract: [Publisher, Chinese] 目的： 探讨高甘油三酯血症相关性急性胰腺炎（HTG-AP）患者发展为重症急性胰腺炎或出现器官功能衰竭的风险因素。 方法： 本研究为回顾性队列研究。使用预先设计的数据收集表，收集了2019年1月至2023年12月在我国5家医院诊断为重症急性胰腺炎的2 429例患者的临床数据。男性1 516例，女性913例；年龄（50.2±16.5）岁（范围：11~99岁）。其中HTG-AP患者353例（16.1%），非HTG-AP患者1 846例（83.9%）。HTG-AP 的定义为血清甘油三酯水平>500 mg/dl，并排除其他病因。组间比较采用独立样本 t 检验、Mann-Whitney U 检验或 χ 2 检验。通过单因素和多因素Logistic回归分析，调整潜在的混杂因素后，评估重症急性胰腺炎的风险因素，建立并验证预测模型。 结果： 与非HTG-AP患者相比，HTG-AP患者发展为重症急性胰腺炎（ OR =1.415，95% CI ：0.866~2.312， P =0.017）和出现器官功能衰竭（ P =0.036， OR =1.256，95% CI ：1.015~1.554）的风险更高。单因素和多因素Logistic回归分析结果显示，HTG-AP患者发展为重症急性胰腺炎的风险因素包括体重指数（ OR =1.856，95% CI ：1.742~1.987， P =0.033）、空腹血糖（ OR =1.128，95% CI ：1.036~1.229， P =0.006）、白细胞计数（ OR =1.162；95% CI ：1.055~1.281， P =0.002）及是否有胸腔积液（ OR =13.151，95% CI ：4.330~19.946， P <0.01）。结合以上风险因素构建HTG-AP发生重症急性胰腺炎的Nomogram预测模型，预测模型在训练集中的曲线下面积为0.877，在测试集中为0.894，具有较好的校准度。 结论： HTG-AP患者发展为重症急性胰腺炎和器官功能衰竭的风险较高。基于体重指数、空腹血糖、白细胞计数及是否有胸腔积液构建的重症急性胰腺炎的风险预测模型有较好的预测价值。.
Substance Nomenclature:
0 (Triglycerides)
0 (Blood Glucose)
Entry Date(s):
Date Created: 20250625 Date Completed: 20250821 Latest Revision: 20250821
Update Code:
20250827
DOI:
10.3760/cma.j.cn112139-20250303-00107
PMID:
40556400
Database:
MEDLINE

Weitere Informationen

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.