Photo Credit: Eranicle
A novel nomogram based on a recent study demonstrated excellent performance in predicting in-hospital mortality of older adults with severe acute pancreatitis.
Age, respiratory rate, arterial pH, total bilirubin, and calcium at admission were important demographic and laboratory factors associated with survival in older adults hospitalized with severe acute pancreatitis, according to a study published online in BMC Gastroenterology.
“These parameters have been used to create a precise and user-friendly nomogram, which could be an effective and valuable clinical tool for clinicians,” wrote the corresponding author Huihui Wang, of Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Yangzhou, China, and study coauthors.
The study included 326 patients aged 65 years and older with severe acute pancreatitis admitted to the intensive care unit at a tertiary teaching hospital, between January 1, 2017, and December 31, 2022. Among the patients, 260 survived, and 66 died.
Multivariate logistic regression analysis identified 5 key independent prognostic factors, measured at hospital admission, of patient survival: age, respiratory rate, arterial pH, total bilirubin, and calcium.
Noting a lack of adequate existing models, researchers developed a nomogram based on the key parameters to provide an efficient tool for predicting in-hospital mortality. They evaluated its performance using metrics such as the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis.
According to the study, the nomogram demonstrated excellent performance in predicting in-hospital mortality of older adults with severe acute pancreatitis, with discrimination and clinical applicability like sequential organ failure assessment (SOFA). Specifically, researchers reported AUC values of 0.794 for the nomogram and 0.710 for SOFA. Calibration curves also showed satisfactory predictive accuracy for the nomogram.
“Moreover, decision curve analysis was used to assess the clinical effectiveness of nomogram-guided medical interventions for older adult patients with severe acute pancreatitis,” researchers wrote. “The findings indicated that nomogram-guided interventions yielded greater net benefits than the SOFA score when the threshold probability ranged from 0.2 to 0.8.”
Although the findings need to be confirmed in larger, multi-center studies, researchers believe the nomogram holds practical value in the treatment of severe acute pancreatitis in older adults.
“This tool shows promise in aiding clinicians to tailor individualized treatment plans for these patients,” they wrote, “ultimately enhancing patient outcomes, conserving medical resources and costs, and facilitating early recovery.”
