Evidence map›Paper›PMID 40770652›Full record

ArticleCritical care (London, England)2025

A prediction model for 'ICU mortality or prolonged ICU stay' in critically unwell patients with acute pancreatitis: insights from a 2003-2020 cohort analysis using the ANZICS-CORE database.

Karthik Venkatesh, Timothy E Schlub, S George Barreto, Christopher R Andersen, Miles P Davenport, Anthony Delaney, Billingsley Kaambwa, Shailesh Bihari, David Pilcher, Sarah C Sasson and 1 more

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Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Karthik VenkateshDepartment of Intensive Care, Princess Alexandra Hospital, Woolloongabba, QLD, Australia. karthik.venkatesh@health.qld.gov.au.
Timothy E SchlubThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
S George BarretoDepartment of Hepato-Pancreato-Biliary Surgery, Flinders Medical Centre, Bedford Park, SA, Australia.
Christopher R AndersenThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Miles P DavenportThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Anthony DelaneyThe George Institute for Global Health, Sydney, NSW, Australia.
Billingsley KaambwaCollege of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Shailesh BihariCollege of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
David PilcherDepartment of Intensive Care, Alfred Hospital, Melbourne, VIC, Australia.
Sarah C SassonThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
P-ANZICS Collaborative

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCritically unwell patients with acute pancreatitis (AP) are at increased risk of mortality and prolonged ICU length of stay (LOS). We quantified the frequency, risk factors and complications of prolonged ICU LOS in a large cohort of critically unwell adult patients with AP and developed a model to predict a low-risk trajectory 'survived ICU with ICU LOS ≤7 days' versus a high-risk trajectory 'ICU mortality or ICU LOS > 7 days'.

methodsA retrospective cohort analysis of adult patients admitted to Australian and New Zealand ICUs with AP between 2003 and 2020 was conducted using the Australian and New Zealand Intensive Care Society Centre for Outcome Reporting and Evaluation database. Data was censored to December 2020 in order to pre-date the COVID-19 pandemic. The incidence, risk factors and outcomes related to prolonged ICU LOS in AP patients was reported. Multivariate logistic regression was used to build a prediction model for a low-risk versus high-risk outcome. Discrimination was performed with 10-fold cross validation and calibration plot analysis was reported. MAIN

results13,275 patients met inclusion criteria; 60% were male, with a mean age 59±18, mean APACHE III 56±26. 2860 (21.6%) had an ICU LOS > 7 days, 1022 (7.7%) died in ICU, and 3557 (26.8%) had a high-risk trajectory. Prolonged ICU LOS was associated with increased ICU mortality (OR 1.57 95% CI 1.43-1.73 p < 0.001), hospital mortality (OR 1.69 95% CI 1.56-1.83 p < 0.001), and resource use: mechanical ventilation (OR 5.99 95% CI 5.21-6.90 p < 0.001), inotrope/vasopressor support (OR 3.27 95% CI 2.82-3.79 p < 0.001) and dialysis (OR 4.12 95% CI 3.63-4.68 p < 0.001). Model accuracy was 79.5%, Cohen K = 0.49 and AUROC 0.827. For a high-risk trajectory, sensitivity was 0.54 and specificity 0.916. APACHE III, PaO2:FiO2 ratio and early mechanical ventilation were the most influential covariates. Prolonged ICU LOS was associated with increased rate of hospital discharge to rehabilitation or a nursing home.

conclusionsMore than a quarter of ICU patients with AP have a high-risk trajectory. Prolonged ICU admissions are associated with significantly worse mortality and hospital outcomes, and increase resource use. Our prediction model, if confirmed in future studies, may present an opportunity for prognostic enrichment in patients with more severe disease.

Indexed as

Hospital MortalityIntensive Care UnitsLength of StayPancreatitisAdultAgedAustraliaCohort StudiesCOVID-19Critical IllnessDatabases, FactualFemaleHumansMaleMiddle AgedNew ZealandCritical illnessIntensive careLength of stayMorbidityPrediction model developmentSevere acute pancreatitis

Identifiers

PMID40770652
PMCPMC12326670

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LicenceCC BY
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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.