The Evaluation of Inflammatory Biomarkers in Predicting Progression of Acute Pancreatitis to Pancreatic Necrosis: A Diagnostic Test Accuracy Review

Riaz, Hafiz Muhammad Asim; Islam, Zara; Rasheed, Lubna; Sarfraz, Zouina; Sarfraz, Azza; Robles‐Velasco, Karla; Sarfraz, Muzna; Chérrez-Ojeda, Iván

doi:10.3390/healthcare11010027

Cited by 5 publications

(6 citation statements)

References 54 publications

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“…PCT, a propeptide secreted by hepatocytes and the thyroid in response to severe inflammation and sepsis, 1,6 serves as a biomarker in distinguishing necrotizing from edematous pancreatitis. 15 Elevated PCT levels have been recognized as early indicators of disease severity.…”

Section: Discussionmentioning

confidence: 99%

“…Acute pancreatitis (AP) is an acute disorder of the exocrine pancreas, which is commonly linked to acinar cell injury and local/systemic inflammatory responses. 1 While most cases of AP are mild and self-limiting, approximately 20% of patients progress to necrotizing pancreatitis (NP), a severe form of the disease associated with a mortality risk of up to 15%-20%. 2 Approximately one-third of patients with NP may develop pancreatic infection during the natural course of AP, thus the relative risk of death is up 2-fold.…”

Section: Introductionmentioning

confidence: 99%

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Development of a Nomogram to Predict the Risk for Acute Necrotizing Pancreatitis

Zhang,

Weng

2024

Gut and Liver

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Background/Aims: Necrotizing pancreatitis (NP) presents a more severe clinical trajectory and increased mortality compared to edematous pancreatitis. Prompt identification of NP is vital for patient prognosis. A risk prediction model for NP among Chinese patients has been developed and validated to aid in early detection.Methods: A retrospective analysis was performed on 218 patients with acute pancreatitis (AP) to examine the association of various clinical variables with NP. The least absolute shrinkage and selection operator (LASSO) regression was utilized to refine variables and select predictors. Subsequently, a multivariate logistic regression was employed to construct a predictive nomogram. The model's accuracy was validated using bootstrap resampling (n=500) and its calibration assessed via a calibration curve. The model's clinical utility was evaluated through decision curve analysis.Results: Of the 28 potential predictors analyzed in 218 AP patients, the incidence of NP was 25.2%. LASSO regression identified 14 variables, with procalcitonin, triglyceride, white blood cell count at 48 hours post-admission, calcium at 48 hours post-admission, and hematocrit at 48 hours post-admission emerging as independent risk factors for NP. The resulting nomogram accurately predicted NP risk with an area under the curve of 0.822, sensitivity of 82.8%, and specificity of 76.4%. The bootstrap-validated area under the curve remained at 0.822 (95% confidence interval, 0.737 to 0.892). This model exhibited excellent calibration and demonstrated greater predictive efficacy and clinical utility for NP than APACHE II, Ranson, and BISAP. Conclusions:We have developed a prediction nomogram of NP that is of great value in guiding clinical decision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of a Nomogram to Predict the Risk for Acute Necrotizing Pancreatitis

Zhang,

Weng

2024

Gut and Liver

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“…The release of LDH was triggered by cytokine-mediated tissue damage in inflammatory disease [ 42 ]. Elevated LDH levels conferred a high sensitivity in early assessment and prediction of the worsening of AP [ 43 , 44 ]. The pancreatic inflammation lead to the capillary leak, intravascular depletion, third-spacing of fluid and even shock.…”

Section: Discussionmentioning

confidence: 99%

Development of a predictive nomogram for acute respiratory distress syndrome in patients with acute pancreatitis complicated with acute kidney injury

Yang,

Kang,

et al. 2023

Renal Failure

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Background Acute respiratory distress syndrome (ARDS) is a common complication in patients with acute pancreatitis (AP), especially when patients complicated with acute kidney injury (AKI), resulting in increased duration of hospitalization and mortality. It is of potential clinical significance to develop a predictive model to identify the the high-risk patients. Method AP patients complicated with AKI from January 2019 to March 2022 were enrolled in this study and randomly divided into training cohort and validation cohort at a ratio of 2:1. The Least absolute shrinkage and selection operator(LASSO) regression and machine learning algorithms were applied to select features. A nomogram was developed based on the multivariate logistic regression. The performance of the nomogram was evaluated by AUC, calibration curves, and decision curve analysis. Results A total of 292 patients were enrolled in the study, with 206 in the training cohort and 86 in the validation cohort. Multivariate logistic analysis showed that IAP (Odds Ratio (OR)=4.60, 95%CI:1.23-18.24, p = 0.02), shock (OR = 12.99, 95%CI:3.47-64.04, p < 0.001), CRP(OR= 26.19, 95%CI:9.37-85.57, p < 0.001), LDH (OR = 13.13, 95%CI:4.76-40.42, p < 0.001) were independent predictors of ARDS. The nomogram was developed based on IAP, shock, CRP and LDH. The nomogram showed good discriminative ability with an AUC value of 0.954 and 0.995 in the training and validation cohort, respectively. The calibration curve indicating good concordance between the predicted and observed values. The DCA showed favorable net clinical benefit. Conclusion This study developed a simple model for predicting ARDS in AP patients complicated with AKI. The nomogram can help clinicians identify high-risk patients and optimize therapeutic strategies.

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“…in 2023, such indicators as C-reactive protein, procalcitonin, and lactate dehydrogenase played a role in predicting the occurrence of pancreatic necrosis. It was determined that the level of C-reactive protein above 200 mg/L has a high sensitivity, and the level of 140 mg/L has a high specificity [15].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for pancreatic necrosis in acute pancreatitis in obese patients

Kovalska,

Dronov,

Ivanets

et al. 2023

Mìžnarodnij endokrinologìčnij žurnal

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Background. Acute pancreatitis is an aseptic inflammation of the pancreas with diverse complications and further development of necrosis of the gland, parapancreatic tissue and possible addition of secondary infection. A significant number of biochemical markers that can be predictors of pancreatitis complications are still being researched. However, most of them are expensive and their indicators are increased only in the first 24–48 hours after the onset of the disease, so they are not used in daily clinical routine. The purpose of this study is to evaluate the factors that indicate an elevated risk of necrosis in acute severe pancreatitis. Materials and methods. A retrospective analysis of 80 patients with acute pancreatitis was performed via creation of a multivariate logistic regression model. Results. The dependence of the risk of pancreatic necrosis on the following factor signs was found: lipase at the onset of the disease (cut-off value = 599.6 U/l, area under the receiver operating characteristic curve (АUС) = 0.72 (95% confidence interval (СІ) 0.57–0.88)), severity of the disease, fibrinogen on day 3 of the disease (cut-off value = 9.7, АUС = 0.65 (95% СІ 0.48–0.81)), C-reactive protein (cut-off value = 175.7 mg/L, AUC = 0.70 (95% CI 0.54–0.86)), and intra-abdominal mean capillary perfusion pressure on the first day of the disease (cut-off value ≤ 63.3 mm Hg, АUС = 0.88 (95% СІ 0.77–0.99)). The autopsy results revealed the presence of necrosis and microthrombosis of the pancreas. Conclusions. Factors that may indicate an increased risk of pancreatic necrosis were high levels of lipase, fibrinogen on the third day of the disease, C-reactive protein, decreased intra-abdominal mean capillary perfusion pressure, severity of the disease, and the presence of portosplenomesentric thrombosis.

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The Evaluation of Inflammatory Biomarkers in Predicting Progression of Acute Pancreatitis to Pancreatic Necrosis: A Diagnostic Test Accuracy Review

Cited by 5 publications

References 54 publications

Development of a Nomogram to Predict the Risk for Acute Necrotizing Pancreatitis

Development of a Nomogram to Predict the Risk for Acute Necrotizing Pancreatitis

Development of a predictive nomogram for acute respiratory distress syndrome in patients with acute pancreatitis complicated with acute kidney injury

Risk factors for pancreatic necrosis in acute pancreatitis in obese patients

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