The prognostic nomogram for predicting mortality of elderly acute pancreatitis patients: A retrospective cohort study of the MIMIC-III database

With the aging of the world population, the number of elderly patients with acute pancreatitis (AP) is increasing. The morbidity and mortality are significantly increased in elderly AP patients. This study aims to establish a model to predict the mortality of elderly patients with AP. The retrospective cohort study included 329 patients aged ≥65 with AP in the Medical Information Mart for Intensive Care-III (MIMIC-III) public database. The nomogram was used to visualize the prognostic model and the calibration curve to evaluate the stability and accuracy of the prediction model. Receiver operating characteristic (ROC) curves were drawn to show the area under the ROC curve (AUC) value which determine the predictive value. The Z test was utilized to compare the difference of AUCs. The independent risk factors for mortality in elderly patients with AP included age (P = .019), pulse oxygen saturation (SpO2) (P = .048), Sequential Organ Failure Assessment (SOFA) (P = .007), simplified acute physiological score II (SAPS II) (P = .013) and red cell distribution width (RDW) (P = .018). The AUC of the nomogram prognostic model based on the above 5 indicators predicting mortality in elderly patients with AP was 0.805, with a sensitivity of 65.2% and a specificity of 85.9%, and the calibration curve showed good performance. In addition, the AUCs of RDW, SOFA, and SAPS II alone were 0.618, 0.759, and 0.729, respectively. A nomogram prognostic model included age, SpO2, SOFA, SAPS II and RDW showed good performance in predicting the mortality of elderly patients with AP.