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Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study

AIM: To explore the risk factors of developing chronic pancreatitis (CP) in patients with acute pancreatitis (AP) and develop a prediction score for CP. METHODS: Using the National Health Insurance Research Database in Taiwan, we obtained large, population-based data of 5971 eligible patients diagno...

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Autores principales: Lin, Yen-Chih, Kor, Chew-Teng, Su, Wei-Wen, Hsu, Yu-Chun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262246/
https://www.ncbi.nlm.nih.gov/pubmed/30510378
http://dx.doi.org/10.3748/wjg.v24.i44.5034
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author Lin, Yen-Chih
Kor, Chew-Teng
Su, Wei-Wen
Hsu, Yu-Chun
author_facet Lin, Yen-Chih
Kor, Chew-Teng
Su, Wei-Wen
Hsu, Yu-Chun
author_sort Lin, Yen-Chih
collection PubMed
description AIM: To explore the risk factors of developing chronic pancreatitis (CP) in patients with acute pancreatitis (AP) and develop a prediction score for CP. METHODS: Using the National Health Insurance Research Database in Taiwan, we obtained large, population-based data of 5971 eligible patients diagnosed with AP from 2000 to 2013. After excluding patients with obstructive pancreatitis and biliary pancreatitis and those with a follow-up period of less than 1 year, we conducted a multivariate analysis using the data of 3739 patients to identify the risk factors of CP and subsequently develop a scoring system that could predict the development of CP in patients with AP. In addition, we validated the scoring system using a validation cohort. RESULTS: Among the study subjects, 142 patients (12.98%) developed CP among patients with RAP. On the other hand, only 32 patients (1.21%) developed CP among patients with only one episode of AP. The multivariate analysis revealed that the presence of recurrent AP (RAP), alcoholism, smoking habit, and age of onset of < 55 years were the four important risk factors for CP. We developed a scoring system (risk score 1 and risk score 2) from the derivation cohort by classifying the patients into low-risk, moderate-risk, and high-risk categories based on similar magnitudes of hazard and validated the performance using another validation cohort. Using the prediction score model, the area under the curve (AUC) [95% confidence interval (CI)] in predicting the 5-year CP incidence in risk score 1 (without the number of AP episodes) was 0.83 (0.79, 0.87), whereas the AUC (95%CI) in risk score 2 (including the number of AP episodes) was 0.84 (0.80, 0.88). This result demonstrated that the risk score 2 has somewhat better prediction performance than risk score 1. However, both of them had similar performance between the derivation and validation cohorts. CONCLUSION: In the study,we identified the risk factors of CP and developed a prediction score model for CP.
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spelling pubmed-62622462018-12-03 Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study Lin, Yen-Chih Kor, Chew-Teng Su, Wei-Wen Hsu, Yu-Chun World J Gastroenterol Retrospective Cohort Study AIM: To explore the risk factors of developing chronic pancreatitis (CP) in patients with acute pancreatitis (AP) and develop a prediction score for CP. METHODS: Using the National Health Insurance Research Database in Taiwan, we obtained large, population-based data of 5971 eligible patients diagnosed with AP from 2000 to 2013. After excluding patients with obstructive pancreatitis and biliary pancreatitis and those with a follow-up period of less than 1 year, we conducted a multivariate analysis using the data of 3739 patients to identify the risk factors of CP and subsequently develop a scoring system that could predict the development of CP in patients with AP. In addition, we validated the scoring system using a validation cohort. RESULTS: Among the study subjects, 142 patients (12.98%) developed CP among patients with RAP. On the other hand, only 32 patients (1.21%) developed CP among patients with only one episode of AP. The multivariate analysis revealed that the presence of recurrent AP (RAP), alcoholism, smoking habit, and age of onset of < 55 years were the four important risk factors for CP. We developed a scoring system (risk score 1 and risk score 2) from the derivation cohort by classifying the patients into low-risk, moderate-risk, and high-risk categories based on similar magnitudes of hazard and validated the performance using another validation cohort. Using the prediction score model, the area under the curve (AUC) [95% confidence interval (CI)] in predicting the 5-year CP incidence in risk score 1 (without the number of AP episodes) was 0.83 (0.79, 0.87), whereas the AUC (95%CI) in risk score 2 (including the number of AP episodes) was 0.84 (0.80, 0.88). This result demonstrated that the risk score 2 has somewhat better prediction performance than risk score 1. However, both of them had similar performance between the derivation and validation cohorts. CONCLUSION: In the study,we identified the risk factors of CP and developed a prediction score model for CP. Baishideng Publishing Group Inc 2018-11-28 2018-11-28 /pmc/articles/PMC6262246/ /pubmed/30510378 http://dx.doi.org/10.3748/wjg.v24.i44.5034 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Lin, Yen-Chih
Kor, Chew-Teng
Su, Wei-Wen
Hsu, Yu-Chun
Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study
title Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study
title_full Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study
title_fullStr Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study
title_full_unstemmed Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study
title_short Risk factors and prediction score for chronic pancreatitis: A nationwide population-based cohort study
title_sort risk factors and prediction score for chronic pancreatitis: a nationwide population-based cohort study
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262246/
https://www.ncbi.nlm.nih.gov/pubmed/30510378
http://dx.doi.org/10.3748/wjg.v24.i44.5034
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