Risk model of parenteral nutrition-associated liver disease in the patients with severe acute pancreatitis
Li Jiaqun
Chen Zhengyi
Zhong Wenzhou
Wang Qiquan
Abstract：Objective To establish a risk model of parenteral nutrition-associated liver disease(PNALD)in the patients with severe acute pancreatitis(SAP),and to explore the related factors causing PNALD.Methods 264 SAP patients admitted to Haikou Hospital,Xiangya School of Medicine,Central South University from January 2020 to August 2023 were selected as the research subjects,and were divided into the training set(n =176)and validation set(n =88)in a2∶1 ratio by the computer-generated random number method.According to whether the training set patients had PNALD,they were divided into PNALD group(n =43)and non-PNALD group(n =133).The independent risk factors of PNALD in the patients with SAP were analyzed by univariate and multivariate analysis,and the classification tree model was constructed.Results Compared with non-PNALD group,the patients in PNALD group had the longer course of disease,the higher NRS2002 score,the longer duration of total parenteral nutrition(TPN),the higher proportion of pancreatic necrosis and acute respiratory distress syndrome(ARDS),the higher levels of blood urea nitrogen(BUN),serum creatinine(SCr),C-reactive protein(CRP),and the lower levels of albumin(ALB)and prealbumin(PAB)(P＜0.05).The course of disease and the duration of TPN were independent risk factors for PNALD in the patients with SAP(P＜0.05),and ALB and PAB were independent protective factors(P＜0.05).The classification tree model showed that the duration of TPN was an important predictor of PNALD,and the income graph and index graph showed that the model had good predictive ability.The calibration curve and receiver operating charactristic(ROC)curve indicated that the model had good accuracy and discrimination.Conclusions The duration of TPN has the greatest effect on the PNALD in the patients with SAP,and the course of disease,ALB and PAB should be paid more attention to.In order to reduce the risk of PNALD,we should focus on relevant factors and formulate prevention strategies in time.
Keywords：Severe acute pancreatitis(SAP)Parenteral nutrition-associated liver disease(PNALD)Classification tree algorithmPrediction model
Publication Date：2023-12-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 954-960 )