Establishment and validation of a nomogram model for predicting ARDS risk in the patients with hypertriglyceridemic acute pancreatitis
Lai Liren
Huang Xiaodong
Liu Siyao
Liu Xiong
Hu Jun
Huang Xianwei
Lin Jiyan
Abstract：Objective To develop a nomogram-based model for early prediction of acute respiratory distress syndrome(ARDS)in the patients with hypertriglyceridemic acute pancreatitis(HTG-AP),and to evaluate its predictive performance and clinical utility.Methods The clinical data of 219 HTG-AP patients admitted to the First Affiliated Hospital of Xiamen University from January 1,2022 to December 31,2023 were retrospectively analyzed.Univariate and multivariate Logistic regression were performed to identify independent risk factors for ARDS,based on this,a nomogram prediction model was constructed.Internal validation was conducted by using Bootstrap 500 resampling to assess the model's performance.Results A total 38 among 219 HTG-AP patients(17.4％)suffered from ARDS.Multivariate Logistic regression identified SpO2/FiO2(S/F),neutrophil-to-lymphocyte ratio(NLR),modified Marshall score,bedside index for severity in acute pancreatitis(BISAP)score,and presence of pleural effusion as independent risk factors for ARDS in HTG-AP patients(all P＜0.05).A nomogram was constructed based on above five factors.The model achieved the area under ROC curve(AUC)of 0.954(95％CI 0.927-0.981,P＜0.001).The calibration curve demonstrated ARDS risk predicted by the model had a good consistency with the actual incidence rate.Decision curve analysis showed that the nomogram provided a notable clinical net benefit when the threshold probability was between 0.2 and 0.8.Conclusions Nomogram model constructed based on S/F,NLR,modified Marshall score,BISAP score,and the presence of pleural effusion can predict increased risk of ARDS in HTG-AP patients early.The model has high prediction accuracy and good clinical practicality.
Keywords：Hypertriglyceridemic acute pancreatitisAcute respiratory distress syndromePrediction modelSpO2/FiO2Neutrophil-to-lymphocyte ratioModified Marshall scoreBedside index for severity in acute pancreatitis scorePleural effusion
Publication Date：2025-11-10
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：7( 950-956 )