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

Abstract

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