The milestone for preventing post-ERCP pancreatitis using novel simplified predictive scoring system: a propensity...

Area of Science:

• Gastroenterology
• Medical Informatics
• Clinical Prediction Models

Background:

• Post-ERCP pancreatitis (PEP) is a significant complication of the trans-papillary approach during ERCP.
• The multi-factorial etiology of PEP makes its development unpredictable.
• Early identification of PEP is crucial for cost containment, reducing admissions, and preventing severe pancreatitis progression.

Purpose of the Study:

• To develop and validate a simplified predictive scoring system for PEP.
• To enable early identification of patients at risk for PEP immediately after ERCP.

Main Methods:

• Retrospective analysis of 3362 trans-papillary ERCP procedures performed between January 1, 2012, and December 31, 2019.
• Identification of significant risk factors using univariate, multivariate, and propensity score analyses.
• Quantification of PEP probability using propensity score analysis and internal validation via bootstrapping.

Main Results:

• A scoring system utilizing five risk factors was established, with four risk stratifications.
• The very high-risk group demonstrated a predicted PEP incidence of 28.79% and severe PEP incidence of 9.09%.
• The prediction model achieved an area under the curve (AUC) of 0.86, with an AUC of 0.81 after internal validation.

Conclusions:

• A simplified predictive scoring system for PEP has been successfully established and validated.
• This system uses five risk factors identified immediately after ERCP.
• The scoring system facilitates the early identification of PEP, aiding clinical management.