The dynamic trajectory of symptom networks in patients with acute pancreatitis during hospitalization

To identify the composition and dynamic changes of symptom clusters in hospitalized acute pancreatitis (AP) patients, and to explore core and bridge symptoms via symptom network analysis, thereby providing a basis for precise symptom management.

A total of 194 AP patients admitted to a tertiary hospital in Mianyang, Sichuan from September 2024 to September 2025 were included. General information and the MD Anderson Symptom Inventory-Gastrointestinal Module were used for daily assessment. Exploratory factor analysis was applied to identify symptom clusters, and symptom networks were constructed using R software to analyze centrality indices.

Three symptom clusters were identified: gastrointestinal symptom cluster, sleep-fatigue symptom cluster, and oropharyngeal-psychological distress symptom cluster. The acute pancreatitis symptom network exhibits a dynamic shift during hospitalization, evolving from an initial predominance of gastrointestinal symptoms to a later profile characterized by oropharyngeal-psychological discomfort and sleep-fatigue clusters. At T0, nausea had the highest strength centrality (rs = 1.698), while fatigue was the strongest bridge symptom (rb = 0.95). At T1, abdominal pain (rs = 1.302) and pain (rb = 0.913) were the most central and bridging symptoms, respectively. At T2, dry mouth (rs = 1.018) and bloating (rb = 0.683) exhibited the highest values. By T3, fatigue (rs = 1.621) and pain (rb = 1.59) again showed the highest centrality and bridge strength. Fatigue and abdominal pain are persistent core symptoms, with pain also serving as a crucial bridge symptom.

Symptom experiences in AP patients change dynamically during hospitalization. Targeting core and bridge symptoms can enhance precision and efficiency in symptom management, reducing the overall symptom burden.