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

Xiaoxing Wei,1,2,&ast; Shengteng Guo,1,&ast; Qinghua Wang1 1School of Nursing (School of Gerontology), Binzhou Medical University, Binzhou, Shandong, People’s Republic of China; 2Intensive Care Unit, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qinghua Wang, Email pingxing05@126.comPurpose: 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 χ 2 = 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