Prognostic nomogram for patients with acute pancreatitis complicated with acute kidney injury: A clinical study based on MIMIC-IV database and a college hospital ICU

Purpose: This study aims to analyze the risk factors influencing the survival and prognosis of patients with acute pancreatitis (AP) complicated by acute kidney injury (AKI) and to develop a nomogram model for predicting the overall survival (OS) of these patients. Patients and methods: 616 patients diagnosed with AP sourced from the MIMIC-IV database. They were randomly divided into a training set and an internal validation set. Another 60 patients from the First Affiliated Hospital of Xi'an Jiaotong University were used as an external validation set. Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors affecting the OS of patients. A nomogram model was developed to predict OS, and its performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). Results: Six independent prognostic factors were identified as predictors of OS in patients with AP combined with AKI. These factors were utilized to construct a nomogram model. The AUC values for predicting 1-year, 3-year, and 5-year OS were 0.796, 0.785, and 0.786 in the training set. In the internal and external validation set, the AUC values were 0.828, 0.833, 0.849 and 0.720, 0.810, 0.750, respectively. Furthermore, the calibration curves for several groups showed good consistency, and DCA suggested its clinical usability. Conclusion: The nomogram constructed in this study has a good predictive value, and can be a clinically applicable and practical prediction tool, facilitating rapid and accurate individualized predictions of the patient survival.