Construction of a nomogram for hypertriglyceridemic severe acute pancreatitis that includes metabolic indexes.

Abstract

Background: Current scoring systems for hypertriglyceridaemia-induced acute pancreatitis (HTG-AP) severity are few and lack reliability. The present work focused on screening predicting factors for HTG-SAP, then constructing and validating the visualization model of HTG-AP severity by combining relevant metabolic indexes.

Methods: Between January 2020 and December 2024, retrospective clinical information for HTG-AP inpatients from Weifang People's Hospital was examined. CT scans of included patients were evaluated for muscle and fat parameters. To identify independent predictors of HTG-SAP, univariate regression, least absolute contraction and selection operator (LASSO) regression, and multivariable logistic regression were conducted. Meanwhile, the nomogram was created for model visualization, and the model was verified for accuracy, consistency, stability, and utility by calibration, clinical decision curve (DCA), as well as receiver operating characteristic (ROC) analyses.

Results: Altogether 244 HTG-AP patients were enrolled, and they were categorized as a severe group (N = 44) or a non-severe group (N = 200) in line with Atlanta classification criteria. The analysis showed that lactate dehydrogenase (LDH), serum creatinine(Scr), visceral adipose tissue index (VATI), serum albumin(ALB), and triglyceride and glucose (TyG) index independently predicted the HTG-AP severity prediction model, and a nomogram was constructed for visualization, with an internally validated Harrell's consistency index (c-index) of 0.966 (95% CI, 0.943-0.989), besides, calibration curves, ROC, and DCA all revealed that the nomogram had good predictive ability.

Conclusion: LDH, Scr, VATI, ALB, and TyG independently predict HTG-SAP, and our constructed prediction model has high sensitivity and specificity, which can early identify HTG-AP severity, with a view to giving appropriate interventions to the patients in time, delaying the progression of the patients' conditions, and reducing the complications.