title: Risk factors and nomogram for pancreatic pseudocysts in chronic pancreatitis: A cohort of 1998 patients.
abstract: OBJECTIVE
  Pancreatic pseudocyst is a common complication of chronic pancreatitis. The identification of risk factors and development of a nomogram for pancreatic pseudocysts in chronic pancreatitis patients may contribute to the early diagnosis and intervention of pancreatic pseudocysts.
  
  
  METHODS
  Patients with chronic pancreatitis admitted to our center from January 2000 to December 2013 were enrolled. Cumulative rates of pancreatic pseudocysts after the onset of chronic pancreatitis and after the diagnosis of chronic pancreatitis were calculated. Patients were randomly assigned, in a 2:1 ratio, to the training and validation cohort. Based on the training cohort, risk factors were identified through Cox proportional hazards regression model, and nomogram was developed. Internal and external validations were performed based on the training and validation cohort, respectively.
  
  
  RESULTS
  With a total of 1998 patients, pancreatic pseudocysts were detected in 228 (11.41%) patients. Age at the onset of chronic pancreatitis, smoking, and severe acute pancreatitis were identified risk factors for pancreatic pseudocysts development while steatorrhea and pancreatic stones were protective factors. Incorporating these five factors, the nomogram achieved good concordance indexes of 0.735 and 0.628 in the training and validation cohorts, respectively, with well-fitted calibration curves.
  
  
  CONCLUSIONS
  The nomogram achieved an individualized prediction of pancreatic pseudocysts development in chronic pancreatitis. It may help the early diagnosis and management of pancreatic pseudocysts.
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Hao
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Bi
authors.affiliation: Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Jun-Tao
authors.initials: JT
authors.lastname: Ji
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.|Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xin
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.|Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zhuan
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Du
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Jin-Huan
authors.initials: JH
authors.lastname: Lin
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Di
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Xiang-Peng
authors.initials: XP
authors.lastname: Zeng
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Ye
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Zou
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.|Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Xie
authors.affiliation: Department of Gastroenterology, Air Force General Hospital, Beijing, China.
authors.forename: Bai-Rong
authors.initials: BR
authors.lastname: Li
authors.affiliation: Department of Traditional Chinese Medicine, Jiangdu Hospital, Yangzhou, China.
authors.forename: Zhao-Hong
authors.initials: ZH
authors.lastname: Zheng
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.|Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Liang-Hao
authors.initials: LH
authors.lastname: Hu
authors.affiliation: Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.|Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zhao-Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D010192:Pancreatic Pseudocyst / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D050500:Pancreatitis, Chronic / Q000150:complications*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult
keywords: chronic pancreatitis; individualized prediction; nomogram; pancreatic pseudocyst; risk factors