Abstract

Pancreatic necrosis is a consistent prognostic factor in acute pancreatitis (AP). However, the clinical scores currently in use are either too complicated or require data that are unavailable on admission or lack sufficient predictive value. We therefore aimed to develop a tool to aid in necrosis prediction. The XGBoost machine learning algorithm processed data from 2387 patients with AP. The confidence of the model was estimated by a bootstrapping method and interpreted via the 10th and the 90th percentiles of the prediction scores. Shapley Additive exPlanations (SHAP) values were calculated to quantify the contribution of each variable provided. Finally, the model was implemented as an online application using the Streamlit Python-based framework. The XGBoost classifier provided an AUC value of 0.757. Glucose, C-reactive protein, alkaline phosphatase, gender and total white blood cell count have the most impact on prediction based on the SHAP values. The relationship between the size of the training dataset and model performance shows that prediction performance can be improved. This study combines necrosis prediction and artificial intelligence. The predictive potential of this model is comparable to the current clinical scoring systems and has several advantages over them.

Details

Title
Early prediction of acute necrotizing pancreatitis by artificial intelligence: a prospective cohort-analysis of 2387 cases
Author
Kiss Szabolcs 1   VIAFID ORCID Logo  ; Pintér József 2 ; Molontay Roland 3   VIAFID ORCID Logo  ; Nagy Marcell 2   VIAFID ORCID Logo  ; Farkas Nelli 4 ; Sipos Zoltán 5 ; Fehérvári Péter 6 ; Pecze László 5 ; Földi Mária 1   VIAFID ORCID Logo  ; Vincze Áron 7 ; Takács Tamás 8 ; Czakó László 8 ; Izbéki Ferenc 9 ; Halász Adrienn 10 ; Boros Eszter 9 ; Hamvas József 11 ; Varga Márta 12 ; Artautas, Mickevicius 13 ; Faluhelyi Nándor 14 ; Farkas Orsolya 14 ; Szilárd, Váncsa 15 ; Nagy, Rita 16 ; Bunduc Stefania 17   VIAFID ORCID Logo  ; Hegyi, Péter Jenő 18 ; Márta Katalin 18 ; Borka Katalin 19 ; Doros Attila 20 ; Hosszúfalusi Nóra 21 ; Zubek László 22 ; Erőss Bálint 18   VIAFID ORCID Logo  ; Molnár Zsolt 23   VIAFID ORCID Logo  ; Párniczky Andrea 24 ; Hegyi Péter 25   VIAFID ORCID Logo  ; Szentesi Andrea 26 ; Bajor Judit 7 ; Szilárd, Gódi 7 ; Sarlós Patrícia 7 ; Czimmer József 7 ; Szabó Imre 7 ; Pár Gabriella 7 ; Illés, Anita 7 ; Hágendorn Roland 7 ; Németh, Balázs Csaba 8 ; Balázs, Kui 8 ; Illés Dóra 8 ; Gajdán László 9 ; Dunás-Varga Veronika 9 ; Fejes Roland 9 ; Papp Mária 27 ; Vitális Zsuzsanna 27 ; Novák János 28 ; Török Imola 29 ; Macarie Melania 29 ; Ramírez-Maldonado, Elena 30 ; Sallinen Ville 31 ; Galeev Shamil 32 ; Bod Barnabás 33 ; Ince Ali Tüzün 34 ; Pécsi Dániel 5 ; Varjú Péter 5 ; Juhász, Márk Félix 24 ; Klementina, Ocskay 15 ; Mikó Alexandra 35 ; Szakács Zsolt 36 

1  University of Szeged, Doctoral School of Clinical Medicine, Faculty of Medicine, Szeged, Hungary (GRID:grid.9008.1) (ISNI:0000 0001 1016 9625); University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); Heim Pál National Pediatric Institute, Budapest, Hungary (GRID:grid.413987.0) (ISNI:0000 0004 0573 5145) 
2  Budapest University of Technology and Economics, Human and Social Data Science Lab, Budapest, Hungary (GRID:grid.6759.d) (ISNI:0000 0001 2180 0451) 
3  Budapest University of Technology and Economics, Human and Social Data Science Lab, Budapest, Hungary (GRID:grid.6759.d) (ISNI:0000 0001 2180 0451); Budapest University of Technology and Economics, Stochastics Research Group, Hungarian Academy of Sciences, Budapest, Hungary (GRID:grid.6759.d) (ISNI:0000 0001 2180 0451) 
4  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); University of Pécs, Institute of Bioanalysis, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
5  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
6  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); University of Veterinary Medicine, Department of Biomathematics and Informatics, Budapest, Hungary (GRID:grid.483037.b) (ISNI:0000 0001 2226 5083) 
7  University of Pécs, Division of Gastroenterology, First Department of Medicine, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
8  University of Szeged, Department of Medicine, Szeged, Hungary (GRID:grid.9008.1) (ISNI:0000 0001 1016 9625) 
9  Szent György Teaching Hospital of County Fejér, Department of Internal Medicine, Székesfehérvár, Hungary (GRID:grid.9008.1) 
10  University of Szeged, Doctoral School of Clinical Medicine, Faculty of Medicine, Szeged, Hungary (GRID:grid.9008.1) (ISNI:0000 0001 1016 9625); Szent György Teaching Hospital of County Fejér, Department of Internal Medicine, Székesfehérvár, Hungary (GRID:grid.9008.1) 
11  Bajcsy-Zsilinszky Hospital, Budapest, Hungary (GRID:grid.414174.3) 
12  BMKK Dr Rethy Pal Hospital, Department of Gastroenterology, Békéscsaba, Hungary (GRID:grid.414174.3) 
13  Vilnius University, Vilnius University Hospital Santaros Clinics, Clinics of Abdominal Surgery, Nephrourology and Gastroenterology, Faculty of Medicine, Vilnius, Lithuania (GRID:grid.6441.7) (ISNI:0000 0001 2243 2806) 
14  University of Pécs, Department of Medical Imaging, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
15  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
16  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); Heim Pál National Pediatric Institute, Budapest, Hungary (GRID:grid.413987.0) (ISNI:0000 0004 0573 5145); Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
17  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Carol Davila University of Medicine and Pharmacy, Doctoral School, Bucharest, Romania (GRID:grid.8194.4) (ISNI:0000 0000 9828 7548) 
18  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, Division of Pancreatic Diseases, Heart and Vascular Center, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
19  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, 2nd Department of Pathology, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
20  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, Department of Transplantation and Surgery, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
21  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, Department of Internal Medicine and Hematology, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
22  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, Department of Anaesthesiology and Intensive Therapy, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
23  Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, Department of Anaesthesiology and Intensive Therapy, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Poznan University of Medical Sciences, Department of Anaesthesiology and Intensive Therapy, Poznan, Poland (GRID:grid.22254.33) (ISNI:0000 0001 2205 0971) 
24  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); Heim Pál National Pediatric Institute, Budapest, Hungary (GRID:grid.413987.0) (ISNI:0000 0004 0573 5145) 
25  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); Semmelweis University, Centre for Translational Medicine, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821); Semmelweis University, Division of Pancreatic Diseases, Heart and Vascular Center, Budapest, Hungary (GRID:grid.11804.3c) (ISNI:0000 0001 0942 9821) 
26  University of Szeged, Doctoral School of Clinical Medicine, Faculty of Medicine, Szeged, Hungary (GRID:grid.9008.1) (ISNI:0000 0001 1016 9625); University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
27  University of Debrecen, Division of Gastroenterology, Department of Internal Medicine, Debrecen, Hungary (GRID:grid.7122.6) (ISNI:0000 0001 1088 8582) 
28  Pándy Kálmán Hospital of Békés County, Gyula, Hungary (GRID:grid.7122.6) 
29  University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, County Emergency Clinical Hospital of Târgu Mures-Gastroenterology Clinic, Targu Mures, Romania (GRID:grid.7122.6) 
30  Consorci Sanitari del Garraf, Sant Pere de Ribes, General Surgery, Barcelona, Spain (GRID:grid.507080.a) (ISNI:0000 0004 1771 101X) 
31  University of Helsinki, Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland (GRID:grid.7737.4) (ISNI:0000 0004 0410 2071) 
32  Saint Luke Clinical Hospital, St. Petersburg, Russia (GRID:grid.7737.4) 
33  Dr. Bugyi István Hospital, Szentes, Hungary (GRID:grid.7737.4) 
34  Hospital of Bezmialem Vakif University, School of Medicine, Istanbul, Turkey (GRID:grid.411675.0) (ISNI:0000 0004 0490 4867) 
35  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); University of Pécs, Department of Medical Genetics, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
36  University of Pécs, Institute for Translational Medicine, Szentágothai Research Centre, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479); University of Pécs, First Department of Medicine, Medical School, Pécs, Hungary (GRID:grid.9679.1) (ISNI:0000 0001 0663 9479) 
Publication year
2022
Publication date
2022
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-022-11517-w
ProQuest document ID
2663155763
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.