Development and validation of a prediction model for moderately severe and severe acute pancreatitis in pregnancy

Table 1 Demographics and clinical characteristics of acute pancreatitis patients in pregnancy

Parameters	MAIP (n = 136)	MSIP (n = 54)	P value
Age	27.61 ± 5.25	29.46 ± 5.57	0.032
Etiology			0.514
Hypertriglyceridemia	50 (36.8)	24 (44.4)
Gallstone	45 (33.1)	19 (35.2)
Other	41 (30.1)	11 (20.4)
Comorbidity
Hypertension	0 (0.0)	2 (3.7)	0.080
Diabetes	8 (5.9)	13 (24.1)	0.001
Fatty liver disease	32 (23.5)	16 (29.6)	0.492
Smoking	3 (2.2)	2 (3.7)	0.937
Drinking	4 (2.9)	1 (1.9)	1.000
Trimester of pregnancy on admission
Early (1–12 wk)	9 (6.6)	3(5.6)
Mid (12–24 wk)	31 (22.8)	10(18.5)
Late (24–40 wk)	96 (70.6)	41(75.9)
Gestational weeks on admission	28.04 ± 7.72	28.80 ± 6.64	0.520
Onset to admission (days)	1.59 ± 1.37	1.88 ± 1.65	0.220
Blood infection	0 (0.0)	8 (14.8)	< 0.001
LOS	7.25 ± 4.27	11.88 ± 7.42	< 0.001
Fetal death	3 (2.2)	13(24.1)	< 0.001
Maternal hospital mortality	0 (0.0)	1(2.9)	0.284
Hematocrit	0.33 ± 0.05	0.32 ± 0.06	0.155
Platelet	164.42 ± 55.01	147.55 ± 65.17	0.072
WBC	12.59 ± 4.71	14.15 ± 4.15	0.035
Neutrophils	10.86 ± 4.40	12.49 ± 3.97	0.019
Lymphocytes	1.01 ± 0.40	0.88 ± 0.47	0.068
Monocytes	0.55 ± 0.23	0.48 ± 0.27	0.064
Alanine aminotransferase	50.94 ± 78.74	19.57 ± 37.40	0.006
Albumin	34.22 ± 3.70	29.36 ± 5.17	< 0.001
Creatinine	42.57 ± 9.30	75.87 ± 100.15	< 0.001
Aspartate aminotransferase	51.17 ± 67.61	35.07 ± 50.13	0.115
Alkaline phosphatase	113.56 ± 52.19	95.38 ± 36.87	0.020
Creatine kinase	36.20 ± 25.87	126.36 ± 213.49	< 0.001
LDH	185.32 ± 66.39	346.93 ± 208.95	< 0.001
Triglyceride	5.87 ± 6.72	12.57 ± 7.34	< 0.001
Cholesterol	7.34 ± 5.63	12.80 ± 6.64	< 0.001
High density lipoprotein	1.40 ± 0.48	1.16 ± 0.39	0.001
Low density lipoprotein	2.24 ± 1.23	1.94 ± 1.59	0.158
Sodium	135.62 ± 3.82	133.57 ± 5.43	0.004
Potassium	3.76 ± 0.34	3.83 ± 0.46	0.294
Chlorine	102.17 ± 4.46	102.44 ± 6.40	0.735

MAIP: Mild acute pancreatitis in pregnancy; MSIP: Moderately severe and severe acute pancreatitis in pregnancy; LOS: Length of hospital stay; WBC: White blood cell; LDH: Lactate dehydrogenase.

Table 2 Demographic and clinical characteristics of patients in training group

	Training set			Test set
Parameters	MAIP (96)	MSIP (38)	P value	MAIP (40)	MSIP (16)	P value
Age	27.16 ± 5.46	30.13 ± 6.09	0.007	28.70 ± 4.60	27.88 ± 3.79	0.528
Etiology			0.620			0.804
Hypertriglyceridemia	32 (33.3)	18 (47.4)		18 (45.0)	7 (43.8)
Gallstone	36 (37.5)	13 (34.2)		9 (22.5)	5 (31.2)
Other	28 (29.2)	7 (18.4)		13 (32.5)	4 (25.0)
Comorbidity
Hypertension	0 (0.0)	2 (5.3)	0.079	0 (0.0)	0 (0.0)	-
Diabetes	6 (6.3)	9 (23.7)	0.012	2 (5.0)	4 (25.0)	0.049
Fatty liver disease	20 (20.8)	11 (28.9)	0.437	12 (30.0)	5 (31.2)	1.000
Smoking	1 (1.0)	2 (5.3)	0.400	2 (5.0)	0 (0.0)	0.909
Drinking	3 (3.1)	1 (2.6)	1.000	1 (2.5)	0 (0.0)	1.000
Trimester of pregnancy on admission
Early (1–12 wk)	6 (6.3)	2 (5.3)		3 (7.5)	1 (6.3)
Mid (12–24 wk)	22 (22.9)	8 (21.1)		9 (22.5)	2 (12.5)
Late (24–40 wk)	68 (70.8)	28 (73.7)		28 (70.0)	13 (81.3)
Gestational weeks on admission	27.53 ± 7.52	29.74 ± 6.34	0.113	29.25 ± 8.15	26.56 ± 7.01	0.252
Onset to admission (d)	1.63 ± 1.35	2.12 ± 1.87	0.090	1.50 ± 1.44	1.29 ± 0.63	0.586
Blood infection	0 (0.0)	6 (15.8)	< 0.001	0 (0.0)	2 (12.5)	0.139
LOS	6.99 ± 4.43	23.11 ± 48.52	< 0.001	7.90 ± 3.63	18.25 ± 12.96	0.001
Fetal death	1 (1.0)	9 (23.7)	< 0.001	2 (5.0)	4 (25.0)	0.049
Maternal hospital mortality	0 (0.0)	1 (2.6)	0.284	0 (0.0)	0 (0.0)	-
Hematocrit	0.33 ± 0.05	0.32 ± 0.06	0.734	0.33 ± 0.05	0.30 ± 0.05	0.040
Platelet	169.57 ± 56.91	141.97 ± 61.66	0.015	152.07 ± 48.61	160.80 ± 73.24	0.604
WBC	12.89 ± 4.82	13.94 ± 4.10	0.239	11.87 ± 4.42	14.64 ± 4.37	0.038
Neutrophils	11.19 ± 4.52	12.34 ± 3.83	0.166	10.09 ± 4.06	12.85 ± 4.39	0.029
Lymphocytes	1.00 ± 0.38	0.91 ± 0.49	0.246	1.01 ± 0.44	0.81 ± 0.41	0.129
Monocytes	0.55 ± 0.23	0.48 ± 0.29	0.147	0.56 ± 0.25	0.47 ± 0.22	0.249
Alanine aminotransferase	55.20 ± 82.18	22.91 ± 44.14	0.024	40.73 ± 69.69	11.62 ± 6.40	0.103
Albumin	34.44 ± 3.72	29.68 ± 5.49	< 0.001	33.71 ± 3.62	28.62 ± 4.41	< 0.001
Creatinine	42.90 ± 9.16	86.27 ± 117.45	< 0.001	41.78 ± 9.69	51.17 ± 22.10	0.030
Aspartate aminotransferase	54.45 ± 69.25	40.67 ± 58.67	0.281	43.33 ± 63.66	21.77 ± 10.97	0.186
Alkaline phosphatase	114.05 ± 51.61	100.65 ± 37.29	0.148	112.39 ± 54.23	82.86 ± 33.70	0.048
creatine kinase	36.46 ± 26.55	129.89 ± 242.89	< 0.001	35.58 ± 24.47	117.98 ± 124.10	< 0.001
LDH	183.85 ± 63.85	356.97 ± 234.19	< 0.001	188.86 ± 72.86	323.09 ± 134.59	< 0.001
Triglyceride	5.44 ± 6.86	12.62 ± 8.01	< 0.001	6.91 ± 6.33	12.46 ± 5.66	0.004
cholesterol	6.79 ± 4.43	12.19 ± 6.18	< 0.001	8.68 ± 7.70	14.24 ± 7.63	0.018
High density lipoprotein	1.42 ± 0.49	1.18 ± 0.39	0.007	1.34 ± 0.43	1.12 ± 0.40	0.078
Low density lipoprotein	2.27 ± 1.18	2.00 ± 1.58	0.282	2.17 ± 1.35	1.78 ± 1.67	0.364
Sodium	135.91 ± 3.19	133.94 ± 5.71	0.012	134.93 ± 5.01	132.68 ± 4.72	0.129
Potassium	3.76 ± 0.30	3.88 ± 0.47	0.075	3.78 ± 0.44	3.71 ± 0.45	0.588
Chlorine	102.63 ± 4.22	103.14 ± 6.80	0.597	101.06 ± 4.85	100.78 ± 5.14	0.849

MAIP: Mild acute pancreatitis in pregnancy; MSIP: Moderately severe and severe acute pancreatitis in pregnancy; LOS: Length of hospital stay; WBC: White blood cell; LDH: Lactate dehydrogenase.

Table 3 Receiver operating characteristic curves at the optimal cut-off point according to different models

Models	AUC	Sensitivity	Specificity
Training set
Logistic model	0.865	0.868	0.771
Random forest model	1.000	1.000	1.000
Validation set
Logistic model	0.853	0.812	0.875
Random forest model	0.870	0.812	0.875

AUC: Area under the receiver operating characteristic curve.