内镜逆行胰胆管造影（ERCP）已成为常规内镜手术，对于诊断和治疗各种疾病（包括胆结石取出以及胆管和胰腺肿瘤的治疗）至关重要。尽管其疗效显着，但 ERCP 后感染，尤其是由耐碳青霉烯类肠杆菌 (CRE) 引起的感染，存在重大风险。这些风ERCP 后 CRE 脓毒症患者的死亡率，并开发列线图来准确预测 30 天死亡风险。分析了 2010 年 1 月至 2022 年 12 月期间经历 ERCP 后 CRE 脓毒症的 195 名患者的数据。通过最小绝对收缩和选择算子（LASSO）回归模型优化变量选择。然后采用多变量逻辑回归分析来开发预测模型，并在区分度、校准和临床实用性方面进行评估。通过引导实现内部验证。列线图包括以下预测因素：年龄 > 80岁（风险比[HR] 2.61）、ERCP前90天内入住重症监护病房（ICU）（HR 2.64）、低蛋白血症（HR 4.55） 、快速Pitt菌血症评分 ≥ 2 (HR 2.61)、ERCP术后胰腺炎(HR 2.52)、不适当的经验治疗(HR 3.48)、延迟确定性治疗(HR 2.64)和治疗持续时间短(< 10天)(HR 5.03) 。该模型表现出很强的辨别力和校准能力。本研究确定了与 ERCP 后 CRE 脓毒症患者 30 天死亡率相关的显着风险因素，并开发了列线图来准确预测这种风险。该工具使医疗保健从业者能够提供个性化的风险评估，并及时针对 CRE 进行适当的治疗，从而降低死亡率。© 2024。作者。

Endoscopic retrograde cholangiopancreatography (ERCP) has become a routine endoscopic procedure that is essential for diagnosing and managing various conditions, including gallstone extraction and the treatment of bile duct and pancreatic tumors. Despite its efficacy, post-ERCP infections - particularly those caused by carbapenem-resistant Enterobacterales (CRE) - present significant risks. These risks highlight the need for accurate predictive models to enhance postprocedural care, reduce the mortality risk associated with post-ERCP CRE sepsis, and improve patient outcomes in the context of increasing antibiotic resistance.This study aimed to examine the risk factors for 30-day mortality in patients with CRE sepsis following ERCP and to develop a nomogram for accurately predicting 30-day mortality risk.Data from 195 patients who experienced post-ERCP CRE sepsis between January 2010 and December 2022 were analyzed. Variable selection was optimized via the least absolute shrinkage and selection operator (LASSO) regression model. Multivariate logistic regression analysis was then employed to develop a predictive model, which was evaluated in terms of discrimination, calibration, and clinical utility. Internal validation was achieved through bootstrapping.The nomogram included the following predictors: age > 80 years (hazard ratio [HR] 2.61), intensive care unit (ICU) admission within 90 days prior to ERCP (HR 2.64), hypoproteinemia (HR 4.55), quick Pitt bacteremia score ≥ 2 (HR 2.61), post-ERCP pancreatitis (HR 2.52), inappropriate empirical therapy (HR 3.48), delayed definitive therapy (HR 2.64), and short treatment duration (< 10 days) (HR 5.03). The model demonstrated strong discrimination and calibration.This study identified significant risk factors associated with 30-day mortality in patients with post-ERCP CRE sepsis and developed a nomogram to accurately predict this risk. This tool enables healthcare practitioners to provide personalized risk assessments and promptly administer appropriate therapies against CRE, thereby reducing mortality rates.© 2024. The Author(s).