• Xihui Jiang, Zhengyan Su, Ya Wang, You Deng, Wei Zhao, Kui Jiang, and Chao Sun.
• Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin 300052, China.
• J Crit Care. 2019 Apr 1; 50: 213-220.

PurposeThe mortality rate of severe acute pancreatitis (AP) is 20-30% even after admission to intensive care unit (ICU). Thus we aimed to develop a laboratory-based nomogram to identify AP patients at high risk for mortality.Materials And MethodsThe primary and validation cohorts were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). Independent predictors were determined using multiple Cox analysis and then assembled to predict survival. The performance of proposed nomogram was evaluated by Harrell's concordance index (C-index) and area under the receiver operating characteristic (AUC) analysis, and subsequently compared with conventional scoring systems.ResultsA total of 342 AP patients admitted to ICU were enrolled, with 30-day, 180-day and 1-year mortality rate of 10.8%, 16.1% and 17.5%, respectively. Independent factors from multivariate Cox model to prognosticate 30-day and 1-year mortality were retrieved. The C-index of 1-year prediction nomogram (0.758, 95%CI: 0.676-0.840) were superior to several prediction approaches, and these findings were further confirmed by applying time-specific AUC analysis. Decision curve analysis indicated our nomogram was feasible in clinical practice. Similar results were observed in the validation cohort.ConclusionsThe proposed nomogram gives rise to accurately prognostic prediction for critically AP patients admitted to ICU.Copyright © 2018. Published by Elsevier Inc.

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