肝胆胰外科杂志2025，Vol.37Issue(10)：666-673,681,9.DOI:10.11952/j.issn.1007-1954.2025.10.003
中度重症急性胰腺炎和重症急性胰腺炎并发急性呼吸衰竭的危险因素分析及预测模型的建立
Risk factors analysis and prediction model establishment of moderate severe acute pancreatitis and severe acute pancreatitis complicated with acute respiratory failure
摘要
Abstract
Objective To identify the risk factors of acute respiratory failure(ARF)in patients with moderately severe acute pancreatitis(MSAP)and severe acute pancreatitis(SAP),and to construct a prediction model for MSAP and SAP patients complicated with ARF.Methods The clinical data of acute pancreatitis(AP)patients admitted to Chengde Central Hospital from January 2019 to May 2024 was retrospectively analyzed.A total of 161 patients with MSAP and SAP were selected for this study.Based on the occurrence of ARF during hospitalization,patients were categorized into the ARF group(n=60)and the non-ARF group(n=101).Univariate analysis and multivariate analysis were performed on the general,laboratory,and etiological data in both groups,to identify the relevant risk factors.The prediction model was constructed and verified,and the nomogram was drawn to visualize the prediction model.The receiver operating characteristic(ROC)curve and the calibration curve were used to assess the predictive efficacy.Results The incidence of ARF in this study was 37.3％(60/161).The hospitalization time in ARF group was significantly longer than that in non-ARF group(P＜0.01).By univariate and multivariate analysis,the risk factors for MSAP and SAP patients complicated with ARF were obtained:heart rate(OR=1.052,95％CI 1.021 to 1.084,P＜0.001),blood urea nitrogen(BUN,OR=1.284,95％CI 1.112 to 1.481,P＜0.001),red blood cell distribution width to albumin ratio(RAR,OR=1 229.754,95％CI 9.579 to 157 881.285,P=0.004)and merge pleural effusion(OR=3.406,95％CI 1.222 to 9.496,P=0.019).Logistic prediction equation derived from the above 4 risk factors:Logit(P)=-11.024+0.051×heart rate+0.250×BUN+7.115×RAR+1.226×merge pleural effusion.The area under the curve(AUC)for above 4 risk factors individually and all combination were 0.724,0.817,0.753,0.661 and 0.896,respectively.The AUC value for combination was significantly higher than that of 4 risk factors individual(P＜0.05).The calibration curve indicated good calibration of the prediction model.Conclusion Increased heart rate,BUN and RAR levels within 48 hours of hospitalization,and merge pleural effusion are independent risk factors for MSAP and SAP patients complicated with ARF.The prediction model based on these 4 risk factors has good prediction performance.关键词
重症急性胰腺炎/急性呼吸衰竭/危险因素/心率/血尿素氮/红细胞分布宽度与白蛋白比值/胸腔积液Key words
severe acute pancreatitis/acute respiratory failure/risk factors/heart rate/blood urea nitrogen/red blood cell distribution width to albumin ratio/merge pleural effusion分类
临床医学引用本文复制引用
甘小冰,檀立端,陈治国..中度重症急性胰腺炎和重症急性胰腺炎并发急性呼吸衰竭的危险因素分析及预测模型的建立[J].肝胆胰外科杂志,2025,37(10):666-673,681,9.基金项目
承德市应用技术研究与开发暨可持续发展议程创新示范区专项科技计划(202305B077). （202305B077）
