ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1607829
This article is part of the Research TopicAcute Pancreatitis Infection: Epidemiology, Prevention, Clinical Characteristics, Treatment, and Prediction: Volume IIView all articles
Development of a nomogram for predicting the intraperitoneal rupture of necrotic collection in patients with necrotizing pancreatitis
Provisionally accepted
Gang Li*
Yang LiuZirui LiuMinchun BuKaiming LiJie YangJingzhu ZhangJing Zhou
Bo Ye
Lin Gao*
Zhihui Tong
Weiqin Li- Nanjing University, Nanjing, China
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Objectives Intraperitoneal rupture of necrotic collection (IRNC) is an extremely rare and severe complication in patients with necrotizing pancreatitis. This study aimed to describe the clinical characteristics of intraperitoneal rupture of necrotic collection and develop a distinct model for predicting the risk of IRNC.Methods This is a single-center, retrospective study. All consecutive patients with a primary diagnosis of necrotizing pancreatitis between January 2017 and December 2018 were screened. A nomogram was developed by multivariable logistic regression and the predictive discrimination, calibration and clinical applicability were tested.Of the 181 patients included, 20 (11%) patients developed intraperitoneal rupture of necrotic collections spontaneously during hospitalization (IRNC group).Compared with non-IRNC group, patients in IRNC group received more emergency open necrosectomy, and had higher incidence of major complications and longer hospital stays. Variables associated with intraperitoneal rupture of necrotic collections included body temperature, total protein, white blood cell, and fibrinogen degradation products. A clinical prediction nomogram was developed for predicting the rupture and it exhibited a better discrimination than the currently available parameters, with an area under the ROC curve of 0.897 (95%CI: 0.835-0.958).We have developed a nomogram to identify patients who are at risk of IRNC. Further studies are needed to externally validate and include more data to enhance the applicability and generalizability of the nomogram.
Keywords: Necrotizing pancreatitis, Intraperitoneal rupture, Clinical Characteristics, nomogram, predictive model
Received: 08 Apr 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Li, Liu, Liu, Bu, Li, Yang, Zhang, Zhou, Ye, Gao, Tong and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gang Li, Nanjing University, Nanjing, China
Lin Gao, Nanjing University, Nanjing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.