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Published on: December 9, 2022
Development and validation of a nomogram for predicting 30-day mortality in DBV-induced sepsis with pancreatic injury
Meng Zhang1, Wei Liu1, Yuxin Niu1
1Department of Infectious Diseases, Tongji Hospital, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Disease, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Abstract:
Dabie Bandavirus (DBV)-induced sepsis is a life-threatening disease in which pancreatic injury (PI) is common, yet its severity determinants and prognostic significance remain unclear. This ambispective multicenter cohort study enrolled 310 patients with confirmed DBV-induced sepsis from three hospitals, including prospective and retrospective cohorts. PI was defined by elevated pancreatic enzymes and classified as mild or severe. Multivariate logistic regression identified independent predictors of severe PI and 30-day mortality. A nomogram (DBV-PI) was developed and externally validated. PI was highly prevalent (86%-90%), with severe PI occurring in 41%-46% of patients. Severe PI was associated with significantly higher 30-day mortality than mild PI in both cohorts (all p < 0.05). GCS score, serum triglyceride, and calcium levels were independent predictors of severe PI. The DBV-PI nomogram, incorporating age, GCS score, APTT, and calcium, demonstrated excellent discrimination (AUC >0.87), good calibration, and clinical utility. A 74-point cutoff effectively stratified mortality risk. PI is a frequent and prognostically important complication in DBV-Induced Sepsis.
Insights
Pancreatic injury (PI) is common in Dabie Bandavirus (DBV)-induced sepsis. Severe PI significantly increases 30-day mortality, and a new nomogram aids in predicting risk.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Gastroenterology
Background:
- Dabie Bandavirus (DBV)-induced sepsis is a severe condition.
- Pancreatic injury (PI) is a frequent complication of DBV-induced sepsis.
- Determinants and prognostic significance of PI in this context are not well understood.
Purpose of the Study:
- To investigate the prevalence, severity predictors, and prognostic impact of PI in DBV-induced sepsis.
- To develop and validate a predictive model for severe PI and mortality.
Main Methods:
- Ambispective multicenter cohort study of 310 patients with confirmed DBV-induced sepsis.
- PI defined by elevated pancreatic enzymes; classified as mild or severe.
- Multivariate logistic regression and nomogram development (DBV-PI) with external validation.
Main Results:
- PI prevalence was high (86%-90%), with severe PI in 41%-46%.
- Severe PI was significantly associated with higher 30-day mortality (p < 0.05).
- Independent predictors of severe PI included GCS score, serum triglyceride, and calcium.
- The DBV-PI nomogram showed excellent discrimination (AUC >0.87) and clinical utility.
Conclusions:
- Pancreatic injury is a common and prognostically significant complication in DBV-induced sepsis.
- The developed DBV-PI nomogram effectively predicts mortality risk.
- Early identification and management of PI may improve outcomes in DBV-induced sepsis.