A risk nomogram for 30-day mortality in Chinese patients with acute pancreatitis using LASSO-logistic regression

Introduction

Acute pancreatitis (AP) is a prevalent digestive disorder characterized by the premature activation of pancreatic enzymes within the pancreas due to various etiological factors, leading to local tissue damage and multi-organ dysfunction syndrome¹.The prevalence of AP spans from 5 to 30 cases per 100,000 individuals, with an overall case mortality rate of about 5%².The primary etiological factors contributing to AP contain biliary tract disorders, excessive drinking, and hypertriglyceridemia³. Currently, the prevalence of the disease is rising annually, posing significant challenges regarding patients’ economic burden and societal healthcare pressures. The clinical course of the disease is diverse, ranging from mild to moderate and severe acute pancreatitis (SAP), with mortality rates as high as 36–50% in SAP⁴. Consequently, timely and precise evaluation of the patient’s condition is essential for enhancing the patient’s prognosis and mitigating their economic burden.

The nomogram serves as a sophisticated mathematical instrument for predicting disease progression or mortality based on critical parameters, and for calculating the likelihood of clinical events by integrating multiple prognostic weights derived from patient outcome analyses, ultimately benefiting both patients and healthcare professionals⁵.Our research intends to acquire‌ a nomogram for predicting the 30-day mortality risk in AP patients with laboratory factors derived from patient medical record, thereby enhancing prognosis through the early identification of clinically relevant indicators for timely intervention.

Materials and methods

Research design and participants

In the retrospective cohort study, we gathered information on AP patients aged over 18 years old, hospitalized at the First Affiliated Hospital of Nanjing Medical University between January 2017 and December 2019, were suitable for study population.

In the retrospective cohort study, we gathered information on patients aged 18 years or older diagnosed with AP who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2017 to December 2019 and met the inclusion criteria for our study population. The AP diagnosis necessitates the presence of at least two of the following three criteria: (1) upper abdominal discomfort; (2) serum lipase or amylase levels exceeding threefold the upper limit of normal; (3) imaging findings agreed with AP on abdominal imaging⁶.The exclusion criteria are delineated as follows:①Age < 18years; ② Chronic pancreatitis or pancreas carcinoma; ③Severe dysfunction of the...