Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography based on multidimensional indicators

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is a common complication of the procedure. The effective prevention of post-ERCP pancreatitis (PEP) remains a key focus of clinical research.

To develop a prediction model for PEP based on multidimensional clinical indicators and evaluate its clinical application value.

We retrospectively analyzed 183 patients with biliary tract diseases who underwent ERCP at Xuzhou Medical University from January 2020 to June 2023, divided into non-PEP (n = 159) and PEP (n = 24) groups based on PEP development. Baseline and intraoperative data were compared, and PEP-related factors examined via univariate and multivariate logistic regression. Using R, 70% of patients were assigned to training and 30% to testing sets for PEP prediction model development. Model accuracy was evaluated using a calibration curve and receiver operating characteristic (ROC) area under the curve (AUC).

Age, total cholesterol level, history of pancreatitis, pancreatic ductography, bleeding, and intubation time differed significantly between the two groups when baseline data and intraoperative conditions were compared (P < 0.05). Multifactorial logistic regression analysis demonstrated that age [odds ratio (OR) = 0.192, 95% confidence interval (CI): 0.053-0.698], total cholesterol (OR = 0.324, 95%CI: 0.152-0.694), history of pancreatitis (OR = 6.159, 95%CI: 1.770-21.434), pancreatography (OR = 3.726, 95%CI: 1.028-13.507), and bleeding (OR = 3.059, 95%CI: 1.001-9.349) were independently associated with acute pancreatitis after ERCP. The predictive probabilities from the calibration curves had mean errors of 0.021 and 0.030, with ROC AUCs of 0.840 and 0.797 in the training and test sets, respectively.

Age, total cholesterol, pancreatitis history, pancreatic ductography, and bleeding influence the risk of acute PEP. A model incorporating these factors may aid early detection and intervention.