Risk factor analysis and nomogram development for steatorrhea in idiopathic chronic pancreatitis

作者：Yu Liu, Xiao Yi Yin, Dan Wang, Zhi Qi Dong, Lu Hao, Cui Chen, Teng Wang, Di Zhang, Jia Yi, Huai Yu Yang, Juan Li, Ling Ling Zhang, Ya Wei Bi, Yuan Zhang, Lei Xin, Hui Chen, Qi Sheng Zhang, Ting Xie, Guo Tao Lu, Zhao Shen Li, Zhuan Liao, Liang‐Hao Hu · 发表于：Journal of Digestive Diseases · 年份：2022 · DOI：10.1111/1751-2980.13102 · 被引用次数：6 · 研究领域：Pancreatitis Pathology and Treatment、IgG4-Related and Inflammatory Diseases、Endometriosis Research and Treatment

OBJECTIVES: Steatorrhea, a sign of severe pancreatic exocrine insufficiency (PEI), is related to consequences caused by pancreatitis. This study aimed to identify predictors and to construct a nomogram for steatorrhea in idiopathic chronic pancreatitis (ICP). METHODS: ICP patients admitted to our hospital from January 2000 to December 2013 were enrolled in this retrospective-prospective cohort study and randomly assigned to the training and validation cohorts. The cumulative rate of steatorrhea was calculated. A Cox proportional hazard regression model was used to identify predictors for steatorrhea and construct the nomogram. Internal and external validation of the nomogram was then performed. RESULTS: There were 1633 ICP patients enrolled, with a median follow-up duration of 9.8 years and 20.8% (339/1633) of patients developed steatorrhea following onset of ICP. Steatorrhea was observed in 93, 115, and 133 patients at 1, 3, and 5 years following diagnosis of CP, with a cumulative rate of 6.5% (95% confidence interval [CI] 5.1%-7.9%), 8.0% (95% CI 6.2%-9.8%), and 9.3% (95% CI 6.6%-12.0%), respectively. Male sex (hazard ratio [HR] 2.479, P < 0.001), diabetes mellitus at/before diagnosis of ICP (HR 2.274, P = 0.003), and aged less than 18 years at onset of ICP (HR 0.095, P < 0.001) were identified risk factors for steatorrhea. Initial manifestations were associated with development of steatorrhea. The nomogram was proven to have good concordance indexes. CONCLUSIONS: We identi...