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Derivation and validation of the prediabetes self-assessment screening score after acute pancreatitis (PERSEUS)
Affiliation:Department of Surgery, University of Auckland, Auckland, New Zealand
Abstract:Background and aimApproximately 40% of patients develop abnormal glucose metabolism after a single episode of acute pancreatitis. This study aimed to develop and validate a prediabetes self-assessment screening score for patients after acute pancreatitis.MethodsData from non-overlapping training (n = 82) and validation (n = 80) cohorts were analysed. Univariate logistic and linear regression identified variables associated with prediabetes after acute pancreatitis. Multivariate logistic regression developed the score, ranging from 0 to 215. The area under the receiver-operating characteristic curve (AUROC), Hosmer–Lemeshow χ2 statistic, and calibration plots were used to assess model discrimination and calibration. The developed score was validated using data from the validation cohort.ResultsThe score had an AUROC of 0.88 (95% CI, 0.80–0.97) and Hosmer–Lemeshow χ2 statistic of 5.75 (p = 0.676). Patients with a score of ≥75 had a 94.1% probability of having prediabetes, and were 29 times more likely to have prediabetes than those with a score of <75. The AUROC in the validation cohort was 0.81 (95% CI, 0.70–0.92) and the Hosmer–Lemeshow χ2 statistic was 5.50 (p = 0.599). Model calibration of the score showed good calibration in both cohorts.ConclusionThe developed and validated score, called PERSEUS, is the first instrument to identify individuals who are at high risk of developing abnormal glucose metabolism following an episode of acute pancreatitis.
Keywords:Acute pancreatitis  Prediabetes  Post-pancreatitis diabetes mellitus  Screening  Statistical model
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