{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:22:27Z","timestamp":1788340947168,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":244,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emergency Medicine International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertriglyceridemia\u2010induced acute pancreatitis (HTG\u2010AP) is increasingly recognized as a major cause of acute pancreatitis in China. Acute respiratory distress syndrome (ARDS), a severe and early complication, significantly worsens prognosis and increases intensive care unit (ICU) burden. This study aimed to identify early predictive markers of ARDS in patients with HTG\u2010AP, enabling timely risk stratification and clinical intervention to improve outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 111 patients who were diagnosed with HTG\u2010AP and admitted to the emergency ICU (EICU) between August 2022 and December 2024. Patients were categorized into ARDS (\n                      <jats:italic>n<\/jats:italic>\n                      = 61) and non\u2010ARDS (\n                      <jats:italic>n<\/jats:italic>\n                      = 50) groups according to the complications associated with ARDS throughout the progression of the illness. Clinical variables were compared between groups. The Boruta technique was used to choose predictors, and then multivariate logistic regression was used. To assess prediction ability, receiver operating characteristic (ROC) curve analysis was carried out. We performed internal validation using five\u2010fold cross\u2010validation and bootstrap resampling (1000 iterations) to evaluate the model\u2019s capacity for generalization and stability. The clinical utility of the model was assessed using decision curve analysis (DCA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients in the ARDS group had lower serum calcium (Ca\n                      <jats:sup>2+<\/jats:sup>\n                      ) levels (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05) and longer ICU stays, as well as greater 24\u2009h intra\u2010abdominal pressure (IAP), interleukin\u20106 (IL\u20106), lactate dehydrogenase (LDH), and lactate (Lac) levels (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05) compared to the non\u2010ARDS group. NEU, Lac, Cr, 24\u2009h IAP, IL\u20106, and LDH are important possible risk factors, according to the Boruta algorithm. Multivariate logistic regression analysis identified 24\u2009h IAP, IL\u20106, and LDH as independent predictors of concurrent ARDS (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). The areas under the ROC curves (AUC) for 24\u2009h IAP, IL\u20106, and LDH were 0.796 (95% CI: 0.715\u20130.877), 0.770 (95% CI: 0.683\u20130.858), and 0.868 (95% CI: 0.880\u20130.936), respectively (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). When combined, the predictive model yielded an AUC of 0.907 (95% CI: 0.849\u20130.957), with a specificity of 90.00% and a sensitivity of 78.70%, and demonstrated noninferior predictive performance to the existing scoring systems. With an average AUROC score of 0.890 from five\u2010fold cross\u2010validation and a bootstrap\u2010corrected\n                      <jats:italic>C<\/jats:italic>\n                      \u2010index of 0.894, the model shows good discriminatory power. The model\u2019s clinical net benefit was verified by the DCA. Additionally, we have created a free online risk calculator for the general public (https:\/\/ardsprediction.streamlit.app\/).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LDH, IL\u20106, and 24\u2009h IAP are valuable early indicators of ARDS development in patients with HTG\u2010AP. The integrated predictive model demonstrates excellent diagnostic performance and can support early clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/emmi\/8368299","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:57:50Z","timestamp":1788339470000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lactate Dehydrogenase, Interleukin\u20106, and 24\u2009h Intra\u2010Abdominal Pressure Exhibit Early Predictive Value in Hypertriglyceridemic Pancreatitis Complicated by Acute Respiratory Distress Syndrome"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1809-2844","authenticated-orcid":false,"given":"Kaiqiang","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1560-854X","authenticated-orcid":false,"given":"Bin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6505-9951","authenticated-orcid":false,"given":"Ranran","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8148-4175","authenticated-orcid":false,"given":"Lei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)31310-6"},{"key":"e_1_2_13_2_2","article-title":"Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG). Early Plasmapheresis Among Patients With Hypertriglyceridemia-Associated Acute Pancreatitis","volume":"6","author":"Cao L.","year":"2023","journal-title":"Journal of the American Medical Association Network Open"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314657"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0b013e31825d33c1"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2018.11.009"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9947047"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-020-01016-z"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25158283"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/17534666221122592"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202303-0558ws"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2019.154829"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.06.664"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.02.010"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2022.05.064"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.5009\/gnl220356"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-023-08172-0"},{"key":"e_1_2_13_17_2","first-page":"8","article-title":"The Patient With Intra-Abdominal Hypertension","volume":"51","author":"Sakka S. G.","year":"2016","journal-title":"Anasthesiol Intensivmed Notfallmed Schmerzther"},{"key":"e_1_2_13_18_2","first-page":"116","article-title":"Logistic Regression Analysis of Risk Factors for Severe Acute Pancreatitis Complicated by Acute Respiratory Distress Syndrome","volume":"41","author":"Lu Y.","year":"2021","journal-title":"Journal of Tongji University"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1179\/acb.2007.62.s1.011"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/mpa.0000000000000108"},{"key":"e_1_2_13_21_2","first-page":"525","article-title":"Clinical Effect of Fluid Resuscitation Guided by Intra-Abdominal Pressure and Oxygenation Index for Severe Acute Pancreatitis Patients","volume":"34","author":"Zhang H.","year":"2022","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"e_1_2_13_22_2","first-page":"3168","article-title":"Effect of Transpulmonary Pressure-Directed Mechanical Ventilation on Respiration in Severe Acute Pancreatitis Patient With Intraabdominal Hypertension","volume":"95","author":"Wu X.","year":"2015","journal-title":"Zhonghua Yixue Zazhi"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2023.1110765"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2018.10.006"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom11040591"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/1131235"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.55729\/2000-9666.1430"},{"key":"e_1_2_13_28_2","article-title":"Establishmentand Validation of Early Prediction Model Forhypertriglyceridemic Severe Acute Pancreatitis","volume":"22","author":"Yi S. 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