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Prediction for post-ERCP pancreatitis in non-elderly patients with common bile duct stones: a cross-sectional study at a major Chinese tertiary hospital (2015-2023).

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088682 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6947 (Electronic) Linking ISSN: 14726947 NLM ISO Abbreviation: BMC Med Inform Decis Mak Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Cholangiopancreatography, Endoscopic Retrograde*/adverse effects ; Pancreatitis*/etiology ; Pancreatitis*/epidemiology ; Tertiary Care Centers*; Humans ; Female ; Male ; Adult ; China/epidemiology ; Middle Aged ; Cross-Sectional Studies ; Gallstones ; Risk Assessment ; Choledocholithiasis ; East Asian People
    • Abstract:
      Background: Post-ERCP pancreatitis is one of the most common adverse events in ERCP-related procedures. The purpose of this study is to construct an online model to predict the risk of post-ERCP pancreatitis in non-elderly patients with common bile duct stones through screening of relevant clinical parameters.
      Methods: A total of 919 cases were selected from 7154 cases from a major Chinese tertiary hospital. Multivariable logistic regression model was fitted using the variables selected by the LASSO regression from 28 potential predictor variables. The internal and external validation was assessed by evaluating the receiver operating characteristic curve and the area under curve. Restricted cubic spline modelling was used to explore non-linear associations. The interactive Web application developed for risk prediction was built using the R "shiny" package.
      Results: The incidence of post-ERCP pancreatitis was 5.22% (48/919) and significantly higher in non-elderly patients with female, high blood pressure, the history of pancreatitis, difficult intubation, endoscopic sphincterotomy, lower alkaline phosphatase and smaller diameter of common bile duct. The predictive performance in the test and external validation set was 0.915 (95% CI, 0.858-0.972) and 0.838 (95% CI, 0.689-0.986), respectively. The multivariate restricted cubic spline results showed that the incidence of pancreatitis was increased at 33-50 years old, neutrophil percentage > 58.90%, hemoglobin > 131 g/L, platelet < 203.04 or > 241.40 × 109/L, total bilirubin > 18.39 umol / L, aspartate amino transferase < 36.56 IU / L, alkaline phosphatase < 124.92 IU / L, Albumin < 42.21 g / L and common bile duct diameter between 7.25 and 10.02 mm. In addition, a web server was developed that supports query for immediate PEP risk.
      Conclusion: The visualized networked version of the above model is able to most accurately predict the risk of PEP in non-elderly patients with choledocholithiasis and allows clinicians to assess the risk of PEP in real time and provide preventive treatment measures as early as possible.
      (© 2024. The Author(s).)
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    • Grant Information:
      82203856 National Natural Science Foundation of China; No. 2022e07020006 Key Research and Development Project Foundation of Anhui Province
    • Contributed Indexing:
      Keywords: Common bile duct stones; ERCP; Post-ERCP pancreatitis; Prediction
    • Publication Date:
      Date Created: 20240528 Date Completed: 20240529 Latest Revision: 20240910
    • Publication Date:
      20250114
    • Accession Number:
      PMC11134846
    • Accession Number:
      10.1186/s12911-024-02541-z
    • Accession Number:
      38807169