%0 Journal Article
%T Risk factor analysis and nomogram development for steatorrhea in idiopathic chronic pancreatitis.
%A Liu Y
%A Yin XY
%A Wang D
%A Dong ZQ
%A Hao L
%A Chen C
%A Wang T
%A Zhang D
%A Ma JY
%A Yang HY
%A Li J
%A Zhang LL
%A Bi YW
%A Zhang Y
%A Xin L
%A Chen H
%A Zhang QS
%A Xie T
%A Lu GT
%A Li ZS
%A Liao Z
%A Hu LH
%J J Dig Dis
%V 23
%N 5
%D May 2022
%M 35703114
%F 3.366
%R 10.1111/1751-2980.13102
%X OBJECTIVE: 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 identified predictors and developed a nomogram for predicting steatorrhea in ICP. It was recommended that high-risk populations be followed up closely, which might contribute to the early diagnosis and treatment of PEI.