Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study

Abstract

AIMTo explore the risk factors of developing chronic pancreatitis (CP) in patients with acute pancreatitis (AP) and develop a prediction score for CP.METHODSUsing the National Health Insurance Research Database in Taiwan, we obtained large, population-based data of 5971 eligible patients diagnosed with AP from 2000 to 2013. After excluding patients with obstructive pancreatitis and biliary pancreatitis and those with a follow-up period of less than 1 year, we conducted a multivariate analysis using the data of 3739 patients to identify the risk factors of CP and subsequently develop a scoring system that could predict the development of CP in patients with AP. In addition, we validated the scoring system using a validation cohort.RESULTSAmong the study subjects, 142 patients (12.98%) developed CP among patients with RAP. On the other hand, only 32 patients (1.21%) developed CP among patients with only one episode of AP. The multivariate analysis revealed that the presence of recurrent AP (RAP), alcoholism, smoking habit, and age of onset of < 55 years were the four important risk factors for CP. We developed a scoring system (risk score 1 and risk score 2) from the derivation cohort by classifying the patients into low-risk, moderate-risk, and high-risk categories based on similar magnitudes of hazard and validated the performance using another validation cohort. Using the prediction score model, the area under the curve (AUC) [95% confidence interval (CI)] in predicting the 5-year CP incidence in risk score 1 (without the number of AP episodes) was 0.83 (0.79, 0.87), whereas the AUC (95%CI) in risk score 2 (including the number of AP episodes) was 0.84 (0.80, 0.88). This result demonstrated that the risk score 2 has somewhat better prediction performance than risk score 1. However, both of them had similar performance between the derivation and validation cohorts.CONCLUSIONIn the study,we identified the risk factors of CP and developed a prediction score model for CP.

Association between Albumin–Globulin Ratio and Mortality in Patients with Chronic Kidney Disease

“…The study patients were stratified into three AGR groups according to similar magnitudes of hazards for mortality as follows: low AGR group, AGR ≤1.0; moderate AGR group, 1.1≤ AGR <1.3; high AGR group, AGR ≥1.3 ([12]; Supplementary Figure S1). Descriptive statistics of baseline patient characteristics for the three AGR patient groups were shown as a number (percentage) for categorical variables, mean ± standard deviation (SD) for continuous variables of normal distribution, or median (interquartile range, IQR) of non-normal distribution.…”

Observational longitudinal multicentre investigation of acute pancreatitis (GOULASH PLUS): follow-up of the GOULASH study, protocol

“…Sample size calculation for the GOULASH study was based on data extracted from the Hungarian National Registry of AP operated by the HPSG. The calculated sample size of the GOULASH study is 957 participants; however, the sample size calculation for the GOULASH PLUS study was performed based on the data of the HPSG registry and the articles published by Yadav et al 5 and Kin et al 37. Seventy-five newly developed CP is necessary to reach the required 5% alpha and 80% power for the individual biomarkers.…”

Pancreatitis Prevention in Tabuk City, Kingdom of Saudi Arabia: Evaluating Public Knowledge and Raising Awareness of Risk Factors and Symptoms

“…These diseases pose significant public health concerns due to their high mortality rates and the substantial financial burden they place on healthcare systems in numerous nations. Acute pancreatitis (AP), initially deemed self-limiting, has shown an increasing occurrence in Western countries, ranging from 5 to 10 cases per 100,000 to 70 to 80 cases per 100,000 [2].…”