Construction and evaluation a nomogram model for predicting secondary infected pancreatic necrosis of hypertriglyceridemic acute pancreatitis

XIANG Long; WANG Chun-yu; LEI Ran; DU Xing-chi; ZHANG Yi-nuo; ZHANG Hai-tao; JIANG Hong-chi; SUN Bei; TAN Hong-tao

doi:10.19538/j.cjps.issn1005-2208.2026.04.21

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Chinese Journal of Practical Surgery ›› 2026, Vol. 46 ›› Issue (4) : 510-515. DOI: 10.19538/j.cjps.issn1005-2208.2026.04.21

Construction and evaluation a nomogram model for predicting secondary infected pancreatic necrosis of hypertriglyceridemic acute pancreatitis

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Abstract

Objective To investigate the prognostic factors infecting pancreatic necrosis (IPN) secondary to hypertriglyceridemic acute pancreatitis (HTG-AP) and to establish the multiple visualized model of IPN in HTG-AP patients. Methods The clinical data of 119 HTG-AP patients who received treatment at the Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, between September 2019 and December 2024, was retrospectively analyzed. These patients were categorized into IPN group (38 cases) and non-IPN group (81 cases) based on whether IPN occurred. Univariate analysis was initially conducted to identify potential prognostic factors, followed by multivariate logistic regression analysis to determine independent predictors of IPN in HTG-AP. Nomogram model for IPN in HTG-AP patients were established based on independent prognostic factors. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to test the effectiveness of the nomogram model. Results The differences in albumin, calcium, blood urea nitrogen (BUN), procalcitonin (PCT), prothrombin time activity (PTA), high density lipoprotein cholesterol (HDL-C), D-dimer, persistent organ failure (POF) within 72 hours, mean arterial pressure and pleural effusion between the IPN group and non-IPN group were statistically significant (P<0.05). Multivariate logistic regression analysis showed that diagnosed POF within 72 hours of admission (OR=4.110, 95%CI 1.128-14.971, P=0.032), elevation of PCT(OR=1.120, 95%CI 1.005-1.248, P=0.041), declining of PTA (OR=0.946, 95%CI 0.897-0.997, P=0.039) and elevation of D-Dimer (OR=1.148, 95%CI 1.046-1.260, P=0.004), were independent risk factors of IPN in HTG-AP patients. The AUC of this nomogram model was 0.895 (95%CI 0.834-0.957) which demonstrated good calibration and discrimination. Conclusion The nomogram incorporating PCT, PTA, D-Dimer, and POF within 72 hours can early and reliably predict IPN in HTG-AP patients, which could assist surgeons in early identification of high-risk patients.

Key words

hypertriglyceridemic acute pancreatitis / infected pancreatic necrosis / predict / nomogram / complications

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XIANG Long , WANG Chun-yu , LEI Ran , et al . Construction and evaluation a nomogram model for predicting secondary infected pancreatic necrosis of hypertriglyceridemic acute pancreatitis[J]. Chinese Journal of Practical Surgery. 2026, 46(4): 510-515 https://doi.org/10.19538/j.cjps.issn1005-2208.2026.04.21

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