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Prognostic nomogram for acute pancreatitis patients: An analysis of publicly electronic healthcare records in intensive care unit.

Abstract：

PURPOSE:The mortality rate of severe acute pancreatitis (AP) is 20-30% even after admission to intensive care unit (ICU). Thus we aimed to develop a laboratory-based nomogram to identify AP patients at high risk for mortality. MATERIALS AND METHODS:The primary and validation cohorts were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). Independent predictors were determined using multiple Cox analysis and then assembled to predict survival. The performance of proposed nomogram was evaluated by Harrell's concordance index (C-index) and area under the receiver operating characteristic (AUC) analysis, and subsequently compared with conventional scoring systems. RESULTS:A total of 342 AP patients admitted to ICU were enrolled, with 30-day, 180-day and 1-year mortality rate of 10.8%, 16.1% and 17.5%, respectively. Independent factors from multivariate Cox model to prognosticate 30-day and 1-year mortality were retrieved. The C-index of 1-year prediction nomogram (0.758, 95%CI: 0.676-0.840) were superior to several prediction approaches, and these findings were further confirmed by applying time-specific AUC analysis. Decision curve analysis indicated our nomogram was feasible in clinical practice. Similar results were observed in the validation cohort. CONCLUSIONS:The proposed nomogram gives rise to accurately prognostic prediction for critically AP patients admitted to ICU.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Jiang X,Su Z,Wang Y,Deng Y,Zhao W,Jiang K,Sun C

doi

10.1016/j.jcrc.2018.10.030

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

213-220

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(18)30830-X

journal_volume

50

pub_type

杂志文章

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