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Risk Factors Analysis and Nomogram Development for Pancreatic Pseudocyst in Idiopathic Chronic Pancreatitis
1From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai.
Insights
This study identified key risk factors for pancreatic pseudocyst (PPC) development in idiopathic chronic pancreatitis (ICP) patients. A nomogram was created to predict PPC risk, aiding early diagnosis and management.
Area of Science:
- Gastroenterology and Hepatology
- Pancreatic Diseases
- Clinical Epidemiology
Background:
- Idiopathic chronic pancreatitis (ICP) poses a significant risk for developing pancreatic pseudocysts (PPCs).
- Early identification of patients at high risk for PPC is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To identify risk factors associated with pancreatic pseudocyst (PPC) development in patients with idiopathic chronic pancreatitis (ICP).
- To develop and validate a predictive nomogram for early diagnosis of PPC in ICP patients.
Main Methods:
- A cohort of 1633 ICP patients was analyzed using Kaplan-Meier and Cox proportional hazards regression.
- Patients were divided into training (2:1 ratio) and validation groups to develop and test the nomogram.
- Risk factors were identified, and a nomogram was constructed based on the training cohort.
Main Results:
- The cumulative incidence of PPC in ICP patients was 14.7% over a median follow-up of 9.8 years.
- Identified risk factors for PPC include male sex, smoking, prior severe acute pancreatitis, chronic pain, and main pancreatic duct changes.
- The developed nomogram demonstrated good predictive accuracy (concordance indexes).
Conclusions:
- A validated nomogram can effectively estimate the risk of pancreatic pseudocyst development in ICP patients.
- Close monitoring of high-risk individuals identified by the nomogram is recommended for early PPC diagnosis.
Objective:
The study concerns identifying risk factors and developing nomogram for pancreatic pseudocyst (PPC) in idiopathic chronic pancreatitis (ICP) to facilitate early diagnosis.
Methods:
From January 2000 to December 2013, ICP patients admitted to our center were enrolled. Cumulative incidence of PPC was determined by Kaplan-Meier method. Patients were randomized into training group and validation group in a 2:1 ratio. Risk factors of PPC were determined through Cox proportional hazards regression model based on training cohort. The nomogram was constructed according to risk factors.
Results:
Totally, 1633 ICP patients were included with a median follow-up duration of 9.8 years. Pancreatic pseudocyst was observed in 14.7% (240/1633) of patients after ICP onset. The cumulative incidences of PPC were 8.2%, 10.4%, and 12.9% at 3, 5, and 10 years after ICP onset, respectively. Male sex, smoking history, history of severe acute pancreatitis, and chronic pain at/before diagnosis of ICP and complex pathologic changes in main pancreatic duct were recognized as risk factors of PPC development. The nomogram constructed with these risk factors achieved good concordance indexes.
Conclusions:
Risk for PPC could be estimated through the nomogram. High-risk patients were suggested to be followed up closely to help early diagnosis of PPC.
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