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Clinical subtyping of severe acute pancreatitis reveals heterogeneous associations with early management strategies: a multicenter retrospective cohort study - PubMed

5 hours ago
  • #Severe Acute Pancreatitis
  • #Clinical Subphenotyping
  • #Personalized Medicine
  • Identified three stable clinical subphenotypes of severe acute pancreatitis (SAP): K1 (Stable type), K2 (Renal impairment-dominant type), and K3 (Elderly/Hepatic impairment type).
  • K2 subphenotype had the highest in-hospital mortality (44.8%), with an adjusted hazard ratio of 6.70 for 28-day mortality compared to K1.
  • Fluid overload (≥2.5L early) increased mortality specifically in K3, while low molecular weight heparin therapy benefited only K2 (aHR=0.66).
  • An XGBoost classifier demonstrated high performance (macro-average AUC up to 0.997) for subphenotype identification.
  • Phenotype-based management strategies could optimize SAP treatment, though findings require prospective validation.