New score APRS may predict risk of ICU admission among acute pancreatitis patients

China: A study has concluded that APRS stratifies Acute Pancreatitis (AP) patients into high and low risk of Intensive care unit (ICU) admission within 48 hours of post-hospitalization. This is clinically valuable in managing and personalized therapeutic selection in such patients.

The findings of the study are published in Digestive Diseases and Sciences.

Lei Yuan, Lei Shen, Mengyao Ji, and Xinyu Wen from the School of Automation, Nanjing University of Information Science and Technology and the Department of Information Center, Wuhan University Renmin Hospital, Wuhan, Hubei, China, conducted a study to develop and validate an easy-to-use risk score (APRS) for AP patients who need ICU treatment within 48 h post-hospitalization.

This was based on the clinical records available.

The study methods are summarised as follows:

• There were three cohorts, namely, the RM cohort (5280), TJ cohort (262) and SN cohort (196).

• The RM cohort had a training set and a test set. The training set had 4220 patients, and the test set had 1060 patients.

• The RM cohort extracted the most predictive features from LASSO and entered them into multivariate analysis.

• The coefficients of the statistically significant variables weighted by the multivariable logistic regression model were used to construct APRS.

• RM, TJ, and SN cohorts validated APRS.

• To evaluate the APRS's discrimination, the C-statistic was employed.

• The area under the receiver operating characteristic curve (AUC) differences were compared using the DeLong test.

The key results of the study could be summarised as follows:

• Five thousand seven hundred thirty-eight patients with a history of AP were enrolled in the study.

• LASSO selected eleven variables and entered them into a multivariate analysis.

• The five factors, namely pleural effusion, ALT/AST, ALB/GLB, urea, and glucose, inferred APRS.

• The C-statistics were 0.905, 95% Confidence Interval and 0.889, 95% Confidence Interval in RM and TJ validation.

• To assist the clinician in assessing early the clinical outcomes of AP patients, an online APRS web-based calculator was constructed.

The researchers concluded that APRS could effectively stratify AP patients into the high and low risk of ICU admission within 48 h post-hospitalization. This offers clinical value in directing treatment and personalising therapeutic selection in such patients.

Further reading:

Yuan, L., Shen, L., Ji, M. et al. A New Risk Score to Predict Intensive Care Unit Admission for Patients with Acute Pancreatitis 48 Hours After Admission: Multicenter Study. Dig Dis Sci (2022). https://doi.org/10.1007/s10620-022-07768-2