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ORIGINAL RESEARCH article
Front. Physiol.
Sec. Gastrointestinal Sciences
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1512144
Analysis of Risk Factors and Construction of a Predictive Model for Severe Acute Pancreatitis Complicated by Sinistral portal hypertension
Provisionally accepted- 1 Graduate School, Tianjin Medical University, Tianjin, China
- 2 Department of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Tianjin Hospital of ITCWM Nankai Hospital, Tianjin, China
- 3 Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, Tianjin Municipality, China
Objective: Sinistral portal hypertension (SPH) is a common complication of severe acute pancreatitis (SAP). Patients with SPH often present asymptomatic, but are at risk of gastrointestinal bleeding and abdominal bleeding due to the presence of varices of the corresponding vessels, which are often fatal. However, there is no prediction model for SAP combined with SPH. This study aimed to identify the risk factors of SAP combined with SPH and to construct a relevant predictive model using independent risk factors.Materials and Methods: The clinical data of 431 SAP patients were collected in this study. According to the presence or absence of SPH, the patients were divided into SPH group (n=126) and non-SPH group (n=305), and 431 patients were randomly assigned to the training set and validation set.Univariate logistics regression analysis was used to screen out the variables with significant differences, and then backward stepwise regression method was used for multivariate logistic regression analysis to determine the independent risk factors of SAP combined with SPH. Then a prediction model was constructed and represented by a nomogram, and the model was verified by internal validation. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive ability and accuracy of the model, and decision curve analysis (DCA) was used to evaluate the clinical value of the model. Results: Multivariate logistic regression analysis showed that male, MCTSI score, white blood cell count (WBC), and portal venous system vascular lesions (PVPSL) were independent risk factors for SAP complicated with SPH. Conclusions: Male, MCTSI score, WBC and PVPSL are independent risk factors for SAP complicated with SPH. The establishment of prediction model for SAP complicated with SPH is of great significance for the prevention and treatment of SPH in clinical practice
Keywords: Severe acute pancreatitis, Sinistral portal hypertension, portal venous system vascular lesions, Independent risk factors, nomogram, Prediction model
Received: 16 Oct 2024; Accepted: 25 Feb 2025.
Copyright: © 2025 Xiao, An, Di and Cui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yunfeng Cui, Department of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Tianjin Hospital of ITCWM Nankai Hospital, Tianjin, China
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