Evidence map›Paper›PMID 39510600›Full record

ArticleBMJ open gastroenterology2024

Development of a nomogram for predicting pancreatic portal hypertension in patients with acute pancreatitis: a retrospective study.

Yingjie Zhang, Qiaoyu Su, Yunling Li, Xianchen Zhan, XiangPing Wang, Linhui Zhang, Hui Luo, Xiaoyu Kang, Yong Lv, Shuhui Liang and 2 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

12 authors.

Yingjie ZhangDepartment of Gastroenterology, Xi'an Medical University, Xi'an, Shaanxi, China.
Qiaoyu SuDepartment of Gastroenterology, Xi'an Medical University, Xi'an, Shaanxi, China.
Yunling LiDepartment of Gastroenterology, Xi'an Medical University, Xi'an, Shaanxi, China.
Xianchen ZhanDepartment of Gastroenterology, Xi'an Medical University, Xi'an, Shaanxi, China.
XiangPing WangXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Linhui ZhangXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Hui LuoXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Xiaoyu KangXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Yong LvXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Shuhui LiangXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Gui RenXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Yanglin PanXijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China yanglinpan@hotmail.com.ORCID 0000-0002-4596-4642

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPancreatic portal hypertension (PPH) is a rare complication of acute pancreatitis (AP) that can lead to severe gastrointestinal bleeding. The risk factors associated with PPH, as well as the overall prognosis, warrant further investigation. This study aims to develop and validate a nomogram to predict PPH in patients with AP.

methodsConsecutive patients with AP from 2015 to 2023 were retrospectively included in the study. Demographic data, clinical manifestations within the first week of AP onset, and initial contrast-enhanced CT findings were used to develop the predictive model. Univariate and multivariate Cox regression analyses were performed to identify risk factors for PPH. Based on the results of the multivariate analysis, a nomogram was developed. The patients were randomly divided into training and validation sets at a 7:3 ratio. The accuracy and discriminative power of the predictive model were assessed using the area under the curve (AUC) from the receiver operating characteristic curve and the calibration curve.

resultsOf the 1473 patients with AP, 107 (7.3%) developed PPH within 6 months (range: 2-22 months) during follow-up. Multivariate regression analysis showed that body mass index (BMI) (HR, 1.10; 95% CI 1.04 to 1.16; p=0.001), moderately severe grade (HR, 9.36; 95% CI 4.58 to 19.13; p<0.001), severe grade (HR, 12.95; 95% CI 6.22 to 26.94; p<0.001), diabetes (HR, 2.26; 95% CI 1.47 to 3.47; p<0.001), acute fluid accumulation (HR, 2.13; 95% CI 1.31 to 3.47; p=0.002), and necrosis (HR, 3.64; 95% CI 2.30 to 5.78; p<0.001) were independent risk factors for PPH. A nomogram for predicting PPH was developed, with the predictive curves showing an AUC of 0.859 at 6 months and 0.846 at 9 months. In the validation set, the AUC at both time points was 0.812.

conclusionIn summary, we identified BMI, moderately severe or severe AP, diabetes, acute fluid accumulation, and necrosis as risk factors for AP-related PPH. Using the largest cohort of patients with AP to date, we developed a highly accurate nomogram with strong discriminative ability for predicting PPH. Future studies with larger sample sizes are necessary to confirm our findings and conduct external validation.

Indexed as

Hypertension, PortalNomogramsPancreatitisAcute DiseaseAdultAgedBody Mass IndexFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesRisk FactorsAcute pancreatitisPancreatic diseasePortal hypertension

Identifiers

PMID39510600
PMCPMC11552527

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.