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

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