Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction
Abstract Objective This study aimed to develop and validate a nomogram to predict the risk of pancreatitis after percutaneous transhepatic biliary stent insertion (PTBS) in patients with malignant biliary obstruction (MBO). Materials and methods We enrolled 314 patients who underwent PTBS for MBO fr...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-022-02554-w |
| _version_ | 1798018400436355072 |
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| author | Chen Xu Yiming Gu Weizhong Zhou Guoxiong Xu Sheng Liu Haibin Shi |
| author_facet | Chen Xu Yiming Gu Weizhong Zhou Guoxiong Xu Sheng Liu Haibin Shi |
| author_sort | Chen Xu |
| collection | DOAJ |
| description | Abstract Objective This study aimed to develop and validate a nomogram to predict the risk of pancreatitis after percutaneous transhepatic biliary stent insertion (PTBS) in patients with malignant biliary obstruction (MBO). Materials and methods We enrolled 314 patients who underwent PTBS for MBO from March 2016 to July 2021 in this retrospective study. We used univariate analysis to identify potential risk factors, while a multivariate logistic regression model was employed to establish a nomogram for predicting the risk of pancreatitis. The discrimination and calibration of the nomogram were evaluated by estimating the area under the receiver operator characteristic curve (AUC) and by bootstrap resampling and visual inspection of the calibration curve. The clinical utility of the nomogram was assessed using decision curve analysis (DCA). Results After the procedure, 41 (13.1%) patients developed pancreatitis. Based on multivariate logistic regression analysis, young age (OR = 2.57, 95% CI 1.16 to 5.69), stent insertion across the papilla (OR = 6.47, 95% CI 2.66 to 15.70), and visualization of the pancreatic duct (OR = 15.40, 95% CI 6.07 to 39.03) were associated with an elevated risk of pancreatitis. Importantly, the performance of the nomogram was satisfactory, with an identical AUC (0.807, 95% CI 0.730 to 0.883) and high-level agreement between predicted and observed probabilities as suggested in calibration curves. The DCA curve subsequently confirmed the clinical utility. Conclusion A predictive nomogram for pancreatitis after PTBS in patients with MBO was successfully established in the present study. |
| first_indexed | 2024-04-11T16:23:25Z |
| format | Article |
| id | doaj.art-850ecdeed88940f0aadac0af6877273c |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-11T16:23:25Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-850ecdeed88940f0aadac0af6877273c2022-12-22T04:14:16ZengBMCBMC Gastroenterology1471-230X2022-11-012211910.1186/s12876-022-02554-wPrognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstructionChen Xu0Yiming Gu1Weizhong Zhou2Guoxiong Xu3Sheng Liu4Haibin Shi5Department of Intervention Radiology, Suzhou Municipal Hospital Affiliated to Nanjing Medical UniversityDepartment of Intervention Radiology, Suzhou Municipal Hospital Affiliated to Nanjing Medical UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Intervention Radiology, Suzhou Municipal Hospital Affiliated to Nanjing Medical UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Objective This study aimed to develop and validate a nomogram to predict the risk of pancreatitis after percutaneous transhepatic biliary stent insertion (PTBS) in patients with malignant biliary obstruction (MBO). Materials and methods We enrolled 314 patients who underwent PTBS for MBO from March 2016 to July 2021 in this retrospective study. We used univariate analysis to identify potential risk factors, while a multivariate logistic regression model was employed to establish a nomogram for predicting the risk of pancreatitis. The discrimination and calibration of the nomogram were evaluated by estimating the area under the receiver operator characteristic curve (AUC) and by bootstrap resampling and visual inspection of the calibration curve. The clinical utility of the nomogram was assessed using decision curve analysis (DCA). Results After the procedure, 41 (13.1%) patients developed pancreatitis. Based on multivariate logistic regression analysis, young age (OR = 2.57, 95% CI 1.16 to 5.69), stent insertion across the papilla (OR = 6.47, 95% CI 2.66 to 15.70), and visualization of the pancreatic duct (OR = 15.40, 95% CI 6.07 to 39.03) were associated with an elevated risk of pancreatitis. Importantly, the performance of the nomogram was satisfactory, with an identical AUC (0.807, 95% CI 0.730 to 0.883) and high-level agreement between predicted and observed probabilities as suggested in calibration curves. The DCA curve subsequently confirmed the clinical utility. Conclusion A predictive nomogram for pancreatitis after PTBS in patients with MBO was successfully established in the present study.https://doi.org/10.1186/s12876-022-02554-wPancreatitisNomogramPercutaneous transhepatic biliary stent insertionMalignant biliary obstruction |
| spellingShingle | Chen Xu Yiming Gu Weizhong Zhou Guoxiong Xu Sheng Liu Haibin Shi Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction BMC Gastroenterology Pancreatitis Nomogram Percutaneous transhepatic biliary stent insertion Malignant biliary obstruction |
| title | Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction |
| title_full | Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction |
| title_fullStr | Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction |
| title_full_unstemmed | Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction |
| title_short | Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction |
| title_sort | prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction |
| topic | Pancreatitis Nomogram Percutaneous transhepatic biliary stent insertion Malignant biliary obstruction |
| url | https://doi.org/10.1186/s12876-022-02554-w |
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