2022 年第 3 期 第 17 卷

老年急性胰腺炎患者并发腹腔感染的危险因素及风险列线图模型建立

Risk factors and risk nomogram model of abdominal infection in elderly patients with acute pancreatitis

作者：胡士英汪湃王帅李小平

英文作者：Hu Shiying Wang Pai Wang Shuai Li Xiaoping

单位：北京市和平里医院消化内科，北京100013

英文单位：Department of Gastroenterology Beijing Hepingli Hospital Beijing 100013 China

关键词：急性胰腺炎；腹腔感染；危险因素；列线图

英文关键词：Acutepancreatitis;Abdominalinfection;Riskfactors;Nomogram

• 摘要：

• 目的 探讨老年急性胰腺炎患者并发腹腔感染的危险因素并建立预测老年急性胰腺炎患者并发腹腔感染的风险列线图模型。方法  选取2017年4月至2019年10月于北京市和平里医院进行诊治的290例老年急性胰腺炎患者作为研究对象。据腹腔感染的发生情况将所选患者分为腹腔感染组（46例）和无腹腔感染组（244例）。采用Logistic回归分析方法筛选老年急性胰腺炎患者并发腹腔感染的危险因素，采用R语言（R3.5.3）软件包建立预测老年急性胰腺炎患者并发腹腔感染的风险列线图模型并评价。结果 290例老年急性胰腺炎患者中46例患者发生腹腔感染，腹腔感染的发生率为15.9%（46/290）。Logistic回归分析结果显示，禁食时间≥24 h、糖尿病、低钙血症、胃肠功能障碍、休克、低氧血症及脏器功能损伤是老年急性胰腺炎患者并发腹腔感染的危险因素（均P<0.05）。列线图模型评价结果显示，模型一致性指数为0.830（95%置信区间：0.796~0.864），校正曲线与理想曲线基本一致，受试者工作特征曲线下面积为0.812，决策曲线显示阈值概率在2%~82%范围内时，具有较高的净获益值。结论  禁食时间≥24 h、糖尿病、低钙血症、胃肠功能障碍、休克、低氧血症及脏器功能损伤等是老年急性胰腺炎患者并发腹腔感染的危险因素，基于危险因素建立的列线图有助于预测老年急性胰腺炎患者并发腹腔感染的发生风险。

• Objective   To investigate the risk factors of abdominal infection in elderly patients with acute pancreatitis, and to establish a nomogram model for predicting the risk of abdominal infection in elderly patients with acute pancreatitis. Methods   Totally 290 elderly patients with acute pancreatitis admitted to Beijing Hepingli Hospital from April 2017 to October 2019 were selected. According to the occurrence of abdominal infection, patients were divided into abdominal infection group(46 cases) and non abdominal infection group(244 Cases). Logistic regression analysis was used to screen the risk factors of abdominal infection in elderly patients with acute pancreatitis. R language(R3.5.3) software package was used to establish and evaluate the risk nomogram model for predicting abdominal infection in elderly patients with acute pancreatitis. Results  Among 290 elderly patients with acute pancreatitis, 46 patients developed abdominal infection, and the incidence of abdominal infection was 15.9%(46/290). Logistic regression analysis showed that fasting time≥24 h, diabetes mellitus, hypocalcemia, gastrointestinal dysfunction, shock, hypoxemia, and organ function damage were risk factors for abdominal infection in elderly patients with acute pancreatitis(all P<0.05). The nomogram model showed that the model consistency index was 0.830(95% confidence interval: 0.796-0.864), the calibration curve was basically consistent with the ideal curve, the area under the receiver operator characteristic curve was 0.812, and the decision curve showed high net benefit value when the threshold probability was in the range of 2% to 82%. Conclusions Fasting time≥24 h, diabetes mellitus, hypocalcemia, gastrointestinal dysfunction, shock, hypoxemia and organ dysfunction are risk factors for abdominal infection in elderly patients with acute pancreatitis. The nomogram based on risk factors is helpful to predict the risk of abdominal infection in elderly patients with acute pancreatitis.