A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model
Background: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a severe and deadly adverse event following ERCP. The ideal method for predicting PEP risk before ERCP has yet to be identified. We aimed to establish a simple PEP risk score model (SuPER model: Support for...
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eLife Sciences Publications Ltd
2025-01-01
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| author | Mitsuru Sugimoto Tadayuki Takagi Tomohiro Suzuki Hiroshi Shimizu Goro Shibukawa Yuki Nakajima Yutaro Takeda Yuki Noguchi Reiko Kobayashi Hidemichi Imamura Hiroyuki Asama Naoki Konno Yuichi Waragai Hidenobu Akatsuka Rei Suzuki Takuto Hikichi Hiromasa Ohira |
| author_facet | Mitsuru Sugimoto Tadayuki Takagi Tomohiro Suzuki Hiroshi Shimizu Goro Shibukawa Yuki Nakajima Yutaro Takeda Yuki Noguchi Reiko Kobayashi Hidemichi Imamura Hiroyuki Asama Naoki Konno Yuichi Waragai Hidenobu Akatsuka Rei Suzuki Takuto Hikichi Hiromasa Ohira |
| author_sort | Mitsuru Sugimoto |
| collection | DOAJ |
| description | Background: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a severe and deadly adverse event following ERCP. The ideal method for predicting PEP risk before ERCP has yet to be identified. We aimed to establish a simple PEP risk score model (SuPER model: Support for PEP Reduction) that can be applied before ERCP.
Methods: This multicenter study enrolled 2074 patients who underwent ERCP. Among them, 1037 patients each were randomly assigned to the development and validation cohorts. In the development cohort, the risk score model for predicting PEP was established via logistic regression analysis. In the validation cohort, the performance of the model was assessed.
Results: In the development cohort, five PEP risk factors that could be identified before ERCP were extracted and assigned weights according to their respective regression coefficients: –2 points for pancreatic calcification, 1 point for female sex, and 2 points for intraductal papillary mucinous neoplasm, a native papilla of Vater, or the pancreatic duct procedures (treated as ‘planned pancreatic duct procedures’ for calculating the score before ERCP). The PEP occurrence rate was 0% among low-risk patients (≤0 points), 5.5% among moderate-risk patients (1–3 points), and 20.2% among high-risk patients (4–7 points). In the validation cohort, the C statistic of the risk score model was 0.71 (95% CI 0.64–0.78), which was considered acceptable. The PEP risk classification (low, moderate, and high) was a significant predictive factor for PEP that was independent of intraprocedural PEP risk factors (precut sphincterotomy and inadvertent pancreatic duct cannulation) (OR 4.2, 95% CI 2.8–6.3; p<0.01).
Conclusions: The PEP risk score allows an estimation of the risk of PEP prior to ERCP, regardless of whether the patient has undergone pancreatic duct procedures. This simple risk model, consisting of only five items, may aid in predicting and explaining the risk of PEP before ERCP and in preventing PEP by allowing selection of the appropriate expert endoscopist and useful PEP prophylaxes.
Funding: No external funding was received for this work. |
| format | Article |
| id | doaj-art-95948fa3636e49369e7e97e3514f76d4 |
| institution | OA Journals |
| issn | 2050-084X |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-95948fa3636e49369e7e97e3514f76d42025-08-20T01:49:53ZengeLife Sciences Publications LtdeLife2050-084X2025-01-011310.7554/eLife.101604A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER modelMitsuru Sugimoto0https://orcid.org/0000-0002-4223-613XTadayuki Takagi1Tomohiro Suzuki2Hiroshi Shimizu3Goro Shibukawa4Yuki Nakajima5Yutaro Takeda6Yuki Noguchi7Reiko Kobayashi8Hidemichi Imamura9Hiroyuki Asama10Naoki Konno11Yuichi Waragai12Hidenobu Akatsuka13Rei Suzuki14Takuto Hikichi15Hiromasa Ohira16Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima, JapanDepartment of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima, JapanDepartment of Gastroenterology, Fukushima Rosai Hospital, Iwaki, JapanDepartment of Gastroenterology, Fukushima Rosai Hospital, Iwaki, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Aizu, JapanDepartment of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Aizu, JapanDepartment of Gastroenterology, Ohta Nishinouchi Hospital, Koriyama, JapanDepartment of Gastroenterology, Ohta Nishinouchi Hospital, Koriyama, JapanDepartment of Gastroenterology, Ohta Nishinouchi Hospital, Koriyama, JapanDepartment of Gastroenterology, Ohta Nishinouchi Hospital, Koriyama, JapanDepartment of Gastroenterology, Fukushima Redcross Hospital, Fukushima, JapanDepartment of Gastroenterology, Fukushima Redcross Hospital, Fukushima, JapanDepartment of Gastroenterology, Soma General Hospital, Soma, JapanDepartment of Gastroenterology, Saiseikai Fukushima General Hospital, Fukushima, JapanDepartment of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima, JapanDepartment of Endoscopy, Fukushima Medical University Hospital, Fukushima, JapanDepartment of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima, JapanBackground: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a severe and deadly adverse event following ERCP. The ideal method for predicting PEP risk before ERCP has yet to be identified. We aimed to establish a simple PEP risk score model (SuPER model: Support for PEP Reduction) that can be applied before ERCP. Methods: This multicenter study enrolled 2074 patients who underwent ERCP. Among them, 1037 patients each were randomly assigned to the development and validation cohorts. In the development cohort, the risk score model for predicting PEP was established via logistic regression analysis. In the validation cohort, the performance of the model was assessed. Results: In the development cohort, five PEP risk factors that could be identified before ERCP were extracted and assigned weights according to their respective regression coefficients: –2 points for pancreatic calcification, 1 point for female sex, and 2 points for intraductal papillary mucinous neoplasm, a native papilla of Vater, or the pancreatic duct procedures (treated as ‘planned pancreatic duct procedures’ for calculating the score before ERCP). The PEP occurrence rate was 0% among low-risk patients (≤0 points), 5.5% among moderate-risk patients (1–3 points), and 20.2% among high-risk patients (4–7 points). In the validation cohort, the C statistic of the risk score model was 0.71 (95% CI 0.64–0.78), which was considered acceptable. The PEP risk classification (low, moderate, and high) was a significant predictive factor for PEP that was independent of intraprocedural PEP risk factors (precut sphincterotomy and inadvertent pancreatic duct cannulation) (OR 4.2, 95% CI 2.8–6.3; p<0.01). Conclusions: The PEP risk score allows an estimation of the risk of PEP prior to ERCP, regardless of whether the patient has undergone pancreatic duct procedures. This simple risk model, consisting of only five items, may aid in predicting and explaining the risk of PEP before ERCP and in preventing PEP by allowing selection of the appropriate expert endoscopist and useful PEP prophylaxes. Funding: No external funding was received for this work.https://elifesciences.org/articles/101604ERCPpost-ERCP pancreatitispredictive risk model |
| spellingShingle | Mitsuru Sugimoto Tadayuki Takagi Tomohiro Suzuki Hiroshi Shimizu Goro Shibukawa Yuki Nakajima Yutaro Takeda Yuki Noguchi Reiko Kobayashi Hidemichi Imamura Hiroyuki Asama Naoki Konno Yuichi Waragai Hidenobu Akatsuka Rei Suzuki Takuto Hikichi Hiromasa Ohira A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model eLife ERCP post-ERCP pancreatitis predictive risk model |
| title | A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model |
| title_full | A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model |
| title_fullStr | A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model |
| title_full_unstemmed | A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model |
| title_short | A new preprocedural predictive risk model for post-endoscopic retrograde cholangiopancreatography pancreatitis: The SuPER model |
| title_sort | new preprocedural predictive risk model for post endoscopic retrograde cholangiopancreatography pancreatitis the super model |
| topic | ERCP post-ERCP pancreatitis predictive risk model |
| url | https://elifesciences.org/articles/101604 |
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