Predictive Value of Troponin I, Creatinine Kinase Isoenzyme and the New Japanese Severity Score in Severe Acute Pancreatitis

Abstract

Purpose

To evaluate troponin I, creatine kinase isoenzyme, and the new Japanese Severity Score(JSS) for predicting Severe Acute Pancreatitis-Associated myocardial Injury(SACI).

Patients and Methods

This retrospective study included 136 patients with Severe Acute Pancreatitis, hospitalized in grade-III hospital from June 1, 2015, to October 31, 2022; selected using convenience sampling method and divided into SACI occurrence (n =34) and SACI non-occurrence (n =102) groups. New JSS evaluated predictive value of each SACI index. Binary logistic regression model compared risk factors and constructed a prediction model. Area under receiver operating characteristic curve (AUC) and Hosmer–Lemeshow goodness of fit test evaluated model’s prediction efficiency and calibration ability.

Results

The incidence of SACI was 25%. Univariate analysis found that troponin I and creatine kinase isoenzyme were significantly different (P < 0.05) and independent risk factors for SACI. The new JSS, troponin I, and creatine kinase isoenzyme were included in the prediction model. The prediction model had a good calibration ability, and its predicted value and the actual observed value were not significantly different (Hosmer–Lemeshow χ2 = 5.408, P = 0.368). AUC of the model was 0.803 (95% CI: 0.689–0.918), and the optimal threshold of the prediction model was 0.318 with the maximum Youden index (0.488). The AUC for internal validation was 0.788 (95% CI: 0.657–0.876), and external validation was 0.761 (95% CI: 0.622–0.832).

Conclusion

Troponin I and creatine kinase isoenzymes combined with the new JSS have a high predictive value for SACI, improving the early prediction and treatment of at-risk patients.

Keywords:

• acute pancreatitis
• new Japanese severity score
• myocardial injury
• prediction model
• pancreatic heart syndrome

Abbreviations

JSS, Japanese Severity Score; SAP, Severe Acute Pancreatitis; SACI, Severe Acute Pancreatitis-Associated myocardial Injury; AUC, Area under receiver operating characteristic curve.

Data Sharing Statement

Data used in this study can be requested from the corresponding author with a justification.

Ethics Approval and Informed Consent

This retrospective study was reviewed and approved by the Ethics Committee of Binzhou Medical University (Lun Yan Batch No. 2023-003). The Ethics Committee did not require signed informed consent from patients because all data were collected from an electronic case database and all patients were discharged from the hospital at the time of data collection. The study team adhered to the Declaration of Helsinki and ensured that the study data were not disclosed to third parties.

Acknowledgments

We thank the intensive care unit staff for their help with data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflict of interest.

Additional information

Funding

This research was funded by the Natural Science Foundation Project of Shandong Province (ZR2022MH117) and the China Social Welfare Foundation Love Fund (HLCXKT-20230124).