Influencing factors for adverse prognosis of patients with severe acute pancreatitis complicated with infection and nomogram risk prediction model construction
Objective To explore the influencing factors for adverse prognosis of patients with severe acute pancreatitis (SAP) complicated with infection and construct the nomogram risk prediction model. Methods A retrospective study was conducted on 118 SAP patients complicated with infection admitted to Jinhua People's Hospital from January 2021 to December 2023. According to the 28-day prognosis,they were divided into a good prognosis group of 80 cases and a poor prognosis group of 38 cases. The clinical data of two groups of patients were compared,multivariate Cox regression analysis was used to identify the factors affecting the prognosis of SAP patients complicated with infection,and a nomogram risk prediction model was constructed to evaluate the prognosis of SAP patients complicated with infection. The performance of these influencing factors and nomogram risk prediction model in predicting the prognosis of SAP patients complicated with infection was evaluated by ROC curve. Results Patients in the poor prognosis group had higher levels of procalcitonin,CRP,Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,and Bedside Index for Severity in Acute Pancreatitis (BISAP) score when compared with the good prognosis group,while their albumin (Alb) levels were lower (all P<0.05). Multivariate Cox regression analysis showed that CRP,APACHE Ⅱ score,and BISAP score were independent risk factors affecting the prognosis of SAP patients complicated with infection (all P<0.05),while Alb was an independent protective factor (P<0.05). A nomogram risk prediction model for prognosis of SAP patients complicated with infection was constructed according to independent influencing factors. Internal validation showed that the model had good predictive ability and a positive net benefit rate (threshold range 0.01-1.00). ROC curve analysis showed that the AUC of the nomogram risk prediction model was higher than that of Alb,CRP,APACHE Ⅱ score,and BISAP score (all P<0.05). Conclusion CRP,APACHE Ⅱ score and BISAP score are independent risk factors affecting the prognosis of patients with SAP complicated with infection,while Alb is an independent protective factor. The nomogram risk prediction model constructed based on the above factors has good predictive efficacy and can be used to clinically screen high-risk patients with poor prognosis.
Severe acute pancreatitisInfectionNomogram risk prediction model
万方数据
维普
