ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1611501
Development and validation of a nomogram model for assessing the severity of acute pancreatitis from the perspective of PICS
Provisionally accepted
Dongquan Liu1,2Hongfei Liu2,3Jiaming Yao2Gan Chen2Weichen Wang2Baoqiang Cao1,2Jinlong Hu1,2*
Wenyong Wu1,2*- 1Anhui Medical University, Hefei, Anhui Province, China
- 2Anhui No 2 Provincial People's Hospital, Hefei, Anhui Province, China
- 3Bengbu Medical College, Bengbu, Anhui Province, China
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Background: Early and convenient prediction of the severity of acute pancreatitis (AP) is crucial for its treatment and prognosis. This study aimed to develop and validate a nomogram model for assessing the risk of severe acute pancreatitis (SAP) based on the theory of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PICS). Methods: A total of 4,930 AP patients from the MIMIC-IV database were selected as the derivation cohort, which was divided into the SAP group (n=975) and non-severe acute pancreatitis (NSAP) group (n=3,955) according to the 2012 Atlanta classification criteria. The 9 hematological indicators collected at the earliest time point within 48-72 hours of admission were subjected to logistic regression analysis, and the statistically significant indicators selected were used to establish the model. A validation cohort consisting of 233 AP patients (34 in the SAP group and 199 in the NSAP group) admitted to the Department of General Surgery, Anhui No.2 Provincial People's Hospital from January 2016 to October 2024 was used to verify the model's performance. Results: Multivariate Logistic regression showed that neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), white blood cell count (WBC), hemoglobin (Hb), and red blood cell distribution width (RDW) were independent predictors of SAP (P<0.05). The nomogram model equation was constructed as follows: logit(P) = ln(2.37)⋅log(NLR) + ln(0.45)⋅log(SII) + ln(2.60)⋅log(WBC) + ln(0.85)⋅Hb + ln(1.14)⋅RDW. The area under the receiver operating characteristic curve (AUC) of the derivation cohort was 0.730 (95% CI: 0.708-0.743), with a Hosmer-Lemeshow test P-value of 0.333. The AUC of the validation cohort was 0.795 (95% CI: 0.703-0.886). Conclusions: The nomogram model based on NLR, SII, WBC, Hb, and RDW has good predictive value for SAP and can provide a convenient tool for early clinical identification of SAP.
Keywords: acute pancreatitis, persistent inflammatory–immunosuppressed–catabolic syndrome, Nutrients consumption, systemic immune–inflammation index, Neutrophil lymphocyte ratio
Received: 14 Apr 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Liu, Liu, Yao, Chen, Wang, Cao, Hu and Wu. 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:
Jinlong Hu, hbphujinlong@163.com
Wenyong Wu, wuwenyong@ahmu.edu.cn
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