{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T14:06:55Z","timestamp":1769263615254,"version":"3.49.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early risk-stratification in hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is challenging within the first 24 h of admission. We assessed whether pleural effusion (PE) detected on early imaging serves as an early predictor for the development of severe HTG-AP (HTG-SAP) and organ failure (OF), compared with BISAP, MCTSI, and C-reactive protein (CRP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study included 296 HTG-AP patients at Xuanwu Hospital from August 2013 to February 2024. PE presence within 24 h was abstracted from chest CT; outcomes were HTG-SAP and OF. Diagnostic performance was evaluated using ROC analysis and DeLong tests, comparing with BISAP, MCTSI, and CRP. The prognostic impact of PE laterality (unilateral vs. bilateral) was also analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PE demonstrated the strongest positive correlation with hypertriglyceridemia-induced severe acute pancreatitis (HTG-SAP) (OR: 6.82; 95% CI: 3.13\u201314.88;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). PE achieved the area under the curve (AUC) of 0.792 (95% CI: 0.742\u20130.837) for HTG-SAP prediction and 0.718 (95% CI: 0.663\u20130.768) for OF anticipation. The predictive accuracy of PE was significantly higher than that of CRP for predicting HTG-SAP (\u0394AUC = 0.106;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004) and comparable for predicting OF (\u0394AUC = 0.055;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.112). There was no significant difference between PE and MCTSI scores in predicting either HTG-SAP or OF. However, PE had a lower predictive accuracy compared with the BISAP for both HTG-SAP (\u0394AUC = 0.057) and OF (\u0394AUC = 0.083;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Despite this, PE still demonstrated substantial predictive value for HTG-SAP and OF. There was no significant difference between unilateral and bilateral pleural effusions in predicting the risk of developing HTG-SAP and OF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PE detected within 24 h is a simple, readily available early radio-graphic marker that identifies patients at high risk for progressing to severe course and OF in HTG-AP. While not superior to BISAP, PE offers pragmatic utility when composite scores or complete laboratories are unavailable and may trigger early monitoring and escalation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1757038","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:45:06Z","timestamp":1769150706000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pleural effusion within 24 h of admission predicts severe hypertriglyceridemia-induced acute pancreatitis and organ failure: retrospective cohort of 296 patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Ziyu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxian","family":"He","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meiru","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihong","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xuanwu Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"633","DOI":"10.5152\/tjg.2020.18335","article-title":"The relationship between triglyceride level and the severity of acute hypertriglyceridemic pancreatitis in Chinese patients.","volume":"31","author":"Sun","year":"2020","journal-title":"Turk J Gastroenterol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"14096","DOI":"10.1038\/s41598-018-32337-x","article-title":"The effect of serum triglyceride concentration on the outcome of acute pancreatitis: systematic review and meta-analysis.","volume":"8","author":"Kiss","year":"2018","journal-title":"Sci Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.jacl.2022.05.064","article-title":"Prevalence, severity and management of hypertriglyceridemia-associated pancreatitis; A 7-year retrospective cohort study at Canadian quaternary care hospitals.","volume":"16","author":"Hassanloo","year":"2022","journal-title":"J Clin Lipidol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.pan.2016.02.011","article-title":"Systematic review of hypertriglyceridemia-induced acute pancreatitis: a more virulent etiology?","volume":"16","author":"Carr","year":"2016","journal-title":"Pancreatology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1038\/ajg.2012.91","article-title":"The \u201cgolden hours\u201d of management in acute pancreatitis.","volume":"107","author":"Fisher","year":"2012","journal-title":"Am J Gastroenterol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"615","DOI":"10.3760\/cma.j.issn.0578-1426.2019.08.016","article-title":"[The severity scoring system and prognostic biological markers of acute pancreatitis].","volume":"58","author":"Chen","year":"2019","journal-title":"Zhonghua Nei Ke Za Zhi."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1698","DOI":"10.1136\/gut.2008.152702","article-title":"The early prediction of mortality in acute pancreatitis: a large population-based study.","volume":"57","author":"Wu","year":"2008","journal-title":"Gut."},{"key":"B8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1159\/000441003","article-title":"Evaluating the ability of the bedside index for severity of acute pancreatitis score to predict severe acute pancreatitis: a meta-analysis.","volume":"25","author":"Yang","year":"2016","journal-title":"Med Princ Pract."},{"key":"B9","doi-asserted-by":"publisher","first-page":"340","DOI":"10.4103\/aam.aam_79_22","article-title":"Modified computed tomography severity index in evaluation of acute pancreatitis and its correlation with clinical outcome: a prospective observational study from a tertiary care teaching hospital.","volume":"22","author":"Dalal","year":"2023","journal-title":"India. 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