Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study
Background Infected pancreatic necrosis (IPN) exacerbates complications in patients with acute pancreatitis (AP), increasing mortality rates if not treated promptly. We aimed to evaluate the predictive value of clinical characteristics within 24 hours of admission for IPN prediction.Methods We condu...
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BMJ Publishing Group
2024-12-01
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| Series: | eGastroenterology |
| Online Access: | https://egastroenterology.bmj.com/content/2/4/e100095.full |
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| author | Hongda Chen Dong Wu Wei Tian Jie Meng Wenhua He Kai Song Yin Zhu Ruifeng Wang Zuoyan Wu Shicheng Zheng Dong Mu |
| author_facet | Hongda Chen Dong Wu Wei Tian Jie Meng Wenhua He Kai Song Yin Zhu Ruifeng Wang Zuoyan Wu Shicheng Zheng Dong Mu |
| author_sort | Hongda Chen |
| collection | DOAJ |
| description | Background Infected pancreatic necrosis (IPN) exacerbates complications in patients with acute pancreatitis (AP), increasing mortality rates if not treated promptly. We aimed to evaluate the predictive value of clinical characteristics within 24 hours of admission for IPN prediction.Methods We conducted a retrospective, multicentre cohort study including 3005 patients with AP from eight hospitals in China. Clinical variables collected within 24 hours after admission were analysed using least absolute shrinkage and selection operator regression (10 cross-validations) for variable selection, followed by multivariate logistic regression to develop an IPN prediction model. Internal cross-validation of the development set and validation of the validation set were performed to ensure robustness. Decision curve analysis was used to evaluate its clinical utility.Results IPN occurred in 176 patients (176/3005, 5.9%). The final model included temperature, respiratory rate, plasma calcium ion concentration, serum urea nitrogen and serum glucose. The area under the receiver operating characteristics curve (AUC) was 0.85 (95% CI 0.81 to 0.89), outperforming widely used severity scoring systems. The model demonstrated robust performance on the internal validation cohort (mean AUC: 0.84) and external validation cohort (AUC: 0.82, 95% CI 0. 77 to 0.87).Conclusion We developed a simple and robust model for predicting IPN in patients with AP, demonstrating strong predictive performance and clinical utility. |
| format | Article |
| id | doaj-art-b1930322aeb04c4f80da806eebd67b0e |
| institution | OA Journals |
| issn | 2766-0125 2976-7296 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
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| series | eGastroenterology |
| spelling | doaj-art-b1930322aeb04c4f80da806eebd67b0e2025-08-20T01:57:32ZengBMJ Publishing GroupeGastroenterology2766-01252976-72962024-12-012410.1136/egastro-2024-100095Early clinical predictors of infected pancreatic necrosis: a multicentre cohort studyHongda Chen0Dong Wu1Wei Tian2Jie Meng3Wenhua He4Kai Song5Yin Zhu6Ruifeng Wang7Zuoyan Wu8Shicheng Zheng9Dong Mu102 Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Gastroenterology, Peking Union Medical College Hospital, Beijing, China6 Department of Gastroenterology, Beijing Fangshan District Liangxiang Hospital, Beijing, China5 Department of Gastroenterology, Affiliated Hospital of Hebei University, Baoding, Hebei, China3 Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China1 Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China9 Department of Gastroenterology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China4 Department of Gastroenterology, The Sixth Hospital of Beijing, Beijing, China7 Department of Gastroenterology, The First People`s Hospital of Longquanyi District Chengdu, Chengdu, Sichuan, China8 Department of Gastroenterology, People`s Liberation Army The General Hospital of Western Theater Command, Chengdu, Sichuan, ChinaBackground Infected pancreatic necrosis (IPN) exacerbates complications in patients with acute pancreatitis (AP), increasing mortality rates if not treated promptly. We aimed to evaluate the predictive value of clinical characteristics within 24 hours of admission for IPN prediction.Methods We conducted a retrospective, multicentre cohort study including 3005 patients with AP from eight hospitals in China. Clinical variables collected within 24 hours after admission were analysed using least absolute shrinkage and selection operator regression (10 cross-validations) for variable selection, followed by multivariate logistic regression to develop an IPN prediction model. Internal cross-validation of the development set and validation of the validation set were performed to ensure robustness. Decision curve analysis was used to evaluate its clinical utility.Results IPN occurred in 176 patients (176/3005, 5.9%). The final model included temperature, respiratory rate, plasma calcium ion concentration, serum urea nitrogen and serum glucose. The area under the receiver operating characteristics curve (AUC) was 0.85 (95% CI 0.81 to 0.89), outperforming widely used severity scoring systems. The model demonstrated robust performance on the internal validation cohort (mean AUC: 0.84) and external validation cohort (AUC: 0.82, 95% CI 0. 77 to 0.87).Conclusion We developed a simple and robust model for predicting IPN in patients with AP, demonstrating strong predictive performance and clinical utility.https://egastroenterology.bmj.com/content/2/4/e100095.full |
| spellingShingle | Hongda Chen Dong Wu Wei Tian Jie Meng Wenhua He Kai Song Yin Zhu Ruifeng Wang Zuoyan Wu Shicheng Zheng Dong Mu Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study eGastroenterology |
| title | Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study |
| title_full | Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study |
| title_fullStr | Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study |
| title_full_unstemmed | Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study |
| title_short | Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study |
| title_sort | early clinical predictors of infected pancreatic necrosis a multicentre cohort study |
| url | https://egastroenterology.bmj.com/content/2/4/e100095.full |
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