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

• Published in: Journal of digestive diseases
• Main Authors: Liu, Yu, Yin, Xiao-Yi, Wang, Dan, Dong, Zhi-Qi, Hao, Lu, Chen, Cui, Wang, Teng, Zhang, Di, Ma, Jia-Yi, Yang, Huai-Yu, Li, Juan, Zhang, Ling-Ling, Bi, Ya-Wei, Zhang, Yuan, Xin, Lei, Chen, Hui, Zhang, Qi-Sheng, Xie, Ting, Lu, Guo-Tao, Li, Zhao-Shen, Liao, Zhuan, Hu, Liang-Hao
• Format: Journal Article
• Language: English
• Published: Australia 15.06.2022
• Subjects: steatorrhea; idiopathic chronic pancreatitis; nomogram; risk factor
• ISSN: 1751-2980

Steatorrhea is the sign of severe pancreatic exocrine insufficiency (PEI) which would cause many secondary diseases. The study aims at identifying predictors and constructing a nomogram for steatorrhea in idiopathic chronic pancreatitis (ICP). Idiopathic chronic pancreatitis patients admitted to our hospital from January 2000 to December 2013 were enrolled in this retrospective-prospective cohort study and assigned to training and validation cohort. Cumulative incidence of steatorrhea was calculated. Cox proportional hazards regression model was used to identify predictors for steatorrhea and develop the nomogram. The nomogram was validated in training cohort and validation cohort. There were 1,633 ICP patients enrolled with the median follow-up duration of 9.8 years. There were 20.8% (339/1,633) patients developed steatorrhea after onset of ICP. Steatorrhea was observed in 93, 115 and 133 patients at 1, 3 and 5 years after diagnosis of CP, with the cumulative incidence 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 gender (hazards ratio (HR) = 2.479, P < 0.001), diabetes mellitus at/before diagnosis of ICP (HR = 2.274, P = 0.003), and adolescent 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 proved to have good concordance indexes. We identified predictors and developed nomogram for predicting steatorrhea in ICP. High-risk populations were recommended to be followed up closely which might contribute to early diagnosis and treatment of PEI. This article is protected by copyright. All rights reserved.