• CRP
• VAS scale
• acute pancreatitis
• predictability
• severity score

• acute respiratory distress syndrome
• artificial neural networks
• severe acute pancreatitis

• Humans
• Pancreatitis/complications
• Pancreatitis/diagnosis
• Retrospective Studies
• Acute Disease
• Respiratory Distress Syndrome/diagnosis
• Respiratory Distress Syndrome/etiology
• Neural Networks, Computer

• Ranson score
• acute pancreatitis
• bedside index of severity in acute pancreatitis
• modified Ranson score
• modified computed tomography severity index

• Guangxi Natural Science Foundation

• BISAP score
• MCTSI score
• Ranson score
• acute pancreatitis
• c-reactive protein/albumin ratio
• prognosis

• acute pancreatitis
• hemorheology
• microcirculation
• red blood cell aggregation
• red blood cell deformability

The frequency of acute hypertriglyceridemic pancreatitis (AHTGP) is increasing worldwide. AHTGP may be associated with a more severe clinical course and greater mortality than pancreatitis caused by other causes. Early identification of patients with severe inclination is essential for clinical decision-making and improving prognosis. Therefore, we first developed and validated a risk prediction score for the severity of AHTGP in Chinese patients.

To develop and validate a risk prediction score for the severity of AHTGP in Chinese patients.

We performed a retrospective study including 243 patients with AHTGP. Patients were randomly divided into a development cohort (n = 170) and a validation cohort (n = 73). Least absolute shrinkage and selection operator and logistic regression were used to screen 42 potential predictive variables to construct a risk score for the severity of AHTGP. We evaluated the performance of the nomogram and compared it with existing scoring systems. Last, we used the best cutoff value (88.16) for severe acute pancreatitis (SAP) to determine the risk stratification classification.

Age, the reduction in apolipoprotein A1 and the presence of pleural effusion were independent risk factors for SAP and were used to construct the nomogram (risk prediction score referred to as AAP). The concordance index of the nomogram in the development and validation groups was 0.930 and 0.928, respectively. Calibration plots demonstrate excellent agreement between the predicted and actual probabilities in SAP patients. The area under the curve of the nomogram (0.929) was better than those of the Bedside Index of Severity in AP (BISAP), Ranson, Acute Physiology and Chronic Health Evaluation (APACHE II), modified computed tomography severity index (MCTSI), and early achievable severity index scores (0.852, 0.825, 0.807, 0.831 and 0.807, respectively). In comparison with these scores, the integrated discrimination improvement and decision curve analysis showed improved accuracy in predicting SAP and better net benefits for clinical decisions. Receiver operating characteristic curve analysis was used to determine risk stratification classification for AHTGP by dividing patients into high-risk and low-risk groups according to the best cutoff value (88.16). The high-risk group (> 88.16) was closely related to the appearance of local and systemic complications, Ranson score ≥ 3, BISAP score ≥ 3, MCTSI score ≥ 4, APACHE II score ≥ 8, C-reactive protein level ≥ 190, and length of hospital stay.

The nomogram could help identify AHTGP patients who are likely to develop SAP at an early stage, which is of great value in guiding clinical decisions.

• Nomogram
• Severity
• Acute pancreatitis
• Prediction model

• Acute Disease
• Apolipoprotein A-I
• C-Reactive Protein/metabolism
• China/epidemiology
• Humans
• Pancreatitis/complications
• Pancreatitis/diagnosis
• Predictive Value of Tests
• Prognosis
• Retrospective Studies
• Risk Factors
• Severity of Illness Index

It is critical to accurately identify patients with severe acute pancreatitis (SAP) and moderately SAP (MSAP) in a timely manner. The study was done to establish two early multi-indicator prediction models of MSAP and SAP.

Clinical data of 469 patients with acute pancreatitis (AP) between 2015 and 2020, at the First Affiliated Hospital of Fujian Medical University, and between 2012 and 2020, at the Affiliated Union Hospital of Fujian Medical University, were retrospectively analyzed. The unweighted predictive score (unwScore) and weighted predictive score (wScore) for MSAP and SAP were derived using logistic regression analysis and were compared with four existing systems using receiver operating characteristic curves.

Seven prognostic indicators were selected for incorporation into models, including white blood cell count, lactate dehydrogenase, C-reactive protein, triglyceride, D-dimer, serum potassium, and serum calcium. The cut-offs of the unwScore and wScore for predicting severity were set as 3 points and 0.513 points, respectively. The unwScore (AUC = 0.854) and wScore (AUC = 0.837) were superior to the acute physiology and chronic health evaluation II score (AUC = 0.526), the bedside index for severity in AP score (AUC = 0.766), and the Ranson score (AUC = 0.693) in predicting MSAP and SAP, which were equivalent to the modified computed tomography severity index score (AUC = 0.823).

The unwScore and wScore have good predictive value for MSAP and SAP, which could provide a valuable clinical reference for management and treatment.

• Image-guided Procedure
• Pancreatic Necrosis
• Pancreatic Pseudocysts
• Pancreatitis, Acute Necrotizing
• Percutaneous Catheter Drainage

• ABC transporter genes
• Chronic pancreatitis
• endoplasmic reticulum
• melatonin
• rat

• Rats
• Animals
• Melatonin/pharmacology
• Melatonin/therapeutic use
• Pancreatitis, Chronic/chemically induced
• Pancreatitis, Chronic/drug therapy
• Pancreatitis, Chronic/prevention & control
• Pancreas
• Multidrug Resistance-Associated Protein 2
• Endoplasmic Reticulum Stress

Objectives

This study explores the characteristics and outcomes, including inpatient mortality, length of stay, and pancreatitis complications in patients hospitalized with acute pancreatitis (AP) with coexisting systemic lupus erythematosus (SLE).

Methods

Patients hospitalized with AP from the National Inpatient Sample from 2014 were selected. Patient characteristics and outcomes of AP were compared between the groups with and without SLE. Age, sex, race, Elixhauser Comorbidity Index (ECI), and etiologies of pancreatitis were measured. The outcomes of interest were inpatient mortality, length of stay, and complications, including respiratory failure, acute renal failure, myocardial infarction, hypotensive shock, sepsis, stroke, and ileus. Chi-squared tests and independent t-tests were used to compare proportions and means, respectively. Multivariate logistic regression analysis was performed to determine if SLE is an independent predictor for the outcomes, adjusting for age, sex, race, ECI, and etiologies of pancreatitis.

Results

Among 434,280 AP patients identified in the study, 3,015 patients had SLE. Among patients hospitalized with AP, those with SLE were younger, more likely to be female, more likely to be non-White, had higher ECI, and stayed longer in the hospital. Patients without SLE were more likely to have a history of cholelithiasis, alcohol abuse, and hypertriglyceridemia. AP patients presenting with SLE were at higher risk for respiratory failure, acute renal failure, hypotensive shock, stroke, and sepsis. Higher inpatient mortality was also associated with coexisting SLE.

Conclusions

Patients admitted for AP with SLE have worse outcomes compared to those without SLE. Understanding the potential effects of SLE on AP and optimizing patient care in this population accordingly may improve the quality of care and outcomes.

• acute pancreatitis
• characteristics
• mortality
• outcomes
• systemic lupus erythematosus

• Pancreatitis
• alcohol
• gallstone
• intensive care
• mortality

• Acute pancreatitis
• Acute renal failure
• Acute respiratory distress syndrome
• Mortality
• Predict
• Retrospective
• Scoring system
• Severity

• complications
• computed tomography severity index
• multiple organ failure
• pancreatitis
• severity