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Develop a Novel Nomogram to Predict Respiratory Failure in Acute Pancreatitis at Early Stage by Xinze Qiu, Fu Huang, Zhiyang Li, Xiaohe Wei, Jiangni Wu, Jiean Huang, Shiquan Liu

Background: Respiratory failure is a common complication in patients suffering from moderately severe or severe acute pancreatitis (AP). The aim of this study was to develop a novel nomogram to predict respiratory failure in AP early.
Methods: Patients, who were hospitalized within 72 hours of AP onset from January 1, 2018, to April 31, 2021 were enrolled in the study. The patients were divided into two groups including respiratory failure group and no respiratory failure group. The demographic characteristics and laboratory parameters were compared between the two groups. A nomogram was established with stepwise logistic regression and “rms” packages of R software. Results: A total of 190 patients were finally included. White blood count, hemoglobin, sodium and calcium were significantly different between the two groups (all p < 0.05). White blood count (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 1.14 - 1.47, p < 0.001), lymphocyte count (OR = 2.92, 95% CI: 1.16 - 7.70, p = 0.023), albumin (OR = 1.15, 95% CI: 1.01 - 1.33, p = 0.045) and calcium (OR = 0.00, 95% CI: 0.00 - 0.01, p < 0.001) were independent risk factors for respiratory failure in AP patients. After stepwise logistic regression was applied, white blood count, albumin, and calcium were used for the construction of the nomogram. The area under the curve (AUC) of the nomogram for respiratory failure was 0.832, which was higher than the BISAP score, and the nomogram possessed high concordance as calibration curves showed.
Conclusions: The nomogram could predict respiratory failure in AP at an early stage with high accuracy.

DOI: 10.7754/Clin.Lab.2021.210826