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Prognostic model of patients with Acute Pancreatitis based on Prothrombin Time - International Normalized Ratio to Albumin Ratio: a single-center retrospective study

biochemistry
emergency-and-critical-care
gastroenterology-and-hepatology
infectious-diseases

Abstract

Background. The prothrombin time-international normalized ratio to albumin ratio (PTAR) is a prognostic biomarker of various diseases. However, its significance in predicting the mortality of acute pancreatitis (AP) remains unknown. We aim to investigate the association between PTAR and the 30-day outcomes in AP patients.

Methods. Data of 965 patients hospitalized with AP between January 2017 and December 2019 were retrospectively analy s ed. The baseline clinical characteristics and laboratory data were collected. Then we used Logistic regression analysis and the least absolute shrinkage and selection operator regression to develop a prognostic nomogram model based on PTAR. The predictive value and calibration ability of the nomogram were evaluated using receiver operating characteristic curve analysis and calibration plots, respectively. Bootstrap technology was used for internal validation.

Results. Overall, 43 of the 965 patients (4.5%) died. Multivariate analysis identified seven risk factors independently associated with 30-day mortality of patients with AP: Age, NE percentage, PLT, FIB, AST, UREA, and PTAR. The model based on influencing factors including PTAR has good discrimination and calibration ability in assessing 30-day mortality rate of AP patients (AUC=0.914, 95% CI:0.877-0.951). Kaplan-Meier survival curve analysis showe d that AP patients with the nomogram value > 0.082 were positive ly correlated with higher 30-day mortality (P < 0.001).

Conclusions. PTAR has good clinical value in evaluat ing 30-day prognosis of patients with AP. The model based on PTAR could be useful alone or complement other conventional measures to aid physicians in clinical treatment and decision-making.

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