# The dynamic trajectory of symptom networks in patients with acute pancreatitis during hospitalization

## TL;DR

This study maps how symptoms in acute pancreatitis patients change during hospitalization, identifying key symptoms that could guide better treatment.

## Contribution

The paper introduces a dynamic symptom network analysis to track symptom clusters and key symptoms in acute pancreatitis patients over time.

## Key findings

- Three symptom clusters were identified: gastrointestinal, sleep-fatigue, and oropharyngeal-psychological distress.
- Fatigue and abdominal pain are persistent core symptoms, with pain also acting as a bridge symptom.
- Symptom networks evolve dynamically during hospitalization, shifting from gastrointestinal to psychological and sleep-related symptoms.

## Abstract

To identify the composition and dynamic changes of symptom clusters in hospitalized acute pancreatitis (AP) patients, and to explore core and bridge symptoms via symptom network analysis, thereby providing a basis for precise symptom management.

A total of 194 AP patients admitted to a tertiary hospital in Mianyang, Sichuan from September 2024 to September 2025 were included. General information and the MD Anderson Symptom Inventory-Gastrointestinal Module were used for daily assessment. Exploratory factor analysis was applied to identify symptom clusters, and symptom networks were constructed using R software to analyze centrality indices.

Three symptom clusters were identified: gastrointestinal symptom cluster, sleep-fatigue symptom cluster, and oropharyngeal-psychological distress symptom cluster. The acute pancreatitis symptom network exhibits a dynamic shift during hospitalization, evolving from an initial predominance of gastrointestinal symptoms to a later profile characterized by oropharyngeal-psychological discomfort and sleep-fatigue clusters. At T0, nausea had the highest strength centrality (rs = 1.698), while fatigue was the strongest bridge symptom (rb = 0.95). At T1, abdominal pain (rs = 1.302) and pain (rb = 0.913) were the most central and bridging symptoms, respectively. At T2, dry mouth (rs = 1.018) and bloating (rb = 0.683) exhibited the highest values. By T3, fatigue (rs = 1.621) and pain (rb = 1.59) again showed the highest centrality and bridge strength. Fatigue and abdominal pain are persistent core symptoms, with pain also serving as a crucial bridge symptom.

Symptom experiences in AP patients change dynamically during hospitalization. Targeting core and bridge symptoms can enhance precision and efficiency in symptom management, reducing the overall symptom burden.