Establishment of Early Multi-Indicator Prediction Models of Moderately Severe Acute Pancreatitis and Severe Acute Pancreatitis

Abstract

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

Predictive value of machine learning for the severity of acute pancreatitis: A systematic review and meta-analysis

“…These newly identified studies were screened based on the inclusion and exclusion criteria. Finally, a total of 33 original studies [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] were included. The literature screening process is illustrated in Fig.…”

“…These studies were conducted in 8 countries, including 1 [ 30 ] in Germany, 1 [ 26 ] in Hungary, 1 [ 17 ] in South Korea, 1 [ 37 ] in Nepal, 1 [ 18 ] in Sweden, 2 [ 20 , 21 ] in UK, 3 [ 22 , 28 , 43 ] in the USA, with the remaining studies conducted in China. Ten [ 23 , 24 , 26 , 27 , 30 , 31 , 34 , 35 , 40 , 41 ] studies were multicenter studies, while two studies [ 18 , 20 ] collected subjects from databases. Eleven studies [ [14] , [15] , [16] , 18 , [20] , [21] , [22] , 25 , 26 , 31 , 35 ] considered overfitting, and k-fold cross-validation was primarily used.…”

“…In terms of statistical methods, ten studies [ 17 , 18 , 25 , 26 , [39] , [40] , [41] , 44 , 45 ] had an EPV <10 in the training set, and nine studies [ [20] , [21] , [22] , 24 , 30 , 33 , 34 , 36 , 46 ] were unable to calculate EPV. In addition, eleven studies [ 14 , 16 , 17 , 21 , 22 , 24 , 29 , 30 , 36 , 37 , 39 ] had no independent validation sets or had independent validation sets with fewer than 100 cases. Two studies [ 15 , 18 ] handled missing values in an unreasonable manner.…”

“…Five studies [ 14 , [16] , [17] , [18] , 21 , 34 ] used a univariate screening method. Eighteen studies [ 17 , 19 , 23 , 24 , [27] , [28] , [29] , [30] , [32] , [33] , [34] , [36] , [37] , [38] , [39] , [43] , [44] , [45] ] did not consider the overfitting, underfitting, and optimal fitting of the model. The final assessment result is shown in Fig.…”

Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence

“…Its application on admission may enhance clinical care and refine management approaches for AP[ 147 ]. He et al [ 148 ] retrospectively analyzed the clinical data of 469 patients with AP, and selected seven prognostic indicators to establish an unweighted predictive score and weighted predictive score for MSAP and SAP. The early multi-indicator prediction models for MSAP and SAP demonstrated robust predictive efficacy, offering a meaningful clinical benchmark for diagnosis and treatment[ 148 ].…”