Risk stratification for postoperative pancreatic fistula using the pancreatic surgery registry StuDoQ|Pancreas of the German Society for General and Visceral Surgery.
Journal
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
21
05
2018
revised:
02
09
2018
accepted:
16
11
2018
pubmed:
20
12
2018
medline:
23
4
2019
entrez:
20
12
2018
Statut:
ppublish
Résumé
Postoperative pancreatic fistula (POPF) is a major factor for morbidity and mortality after pancreatic resection. Risk stratification for POPF is important for adjustment of treatment, selection of target groups in trials and quality assessment in pancreatic surgery. In this study, we built a risk-prediction model for POPF based on a large number of predictor variables from the German pancreatic surgery registry StuDoQ|Pancreas. StuDoQ|Pancreas was searched for patients, who underwent pancreatoduodenectomy from 2014 to 2016. A multivariable logistic regression model with elastic net regularization was built including 66 preoperative und intraoperative parameters. Cross-validation was used to select the optimal model. The model was assessed via area under the ROC curve (AUC) and calibration slope and intercept. A total of N = 2488 patients were included. In the optimal model the predictors selected were texture of the pancreatic parenchyma (soft versus hard), body mass index, histological diagnosis pancreatic ductal adenocarcinoma and operation time. The AUC was 0.70 (95% CI 0.69-0.70), the calibration slope 1.67 and intercept 1.12. In the validation set the AUC was 0.65 (95% CI 0.64-0.66), calibration slope and intercept were 1.22 and 0.42, respectively. The model we present is a valid measurement instrument for POPF risk based on four predictor variables. It can be applied in clinical practice as well as for risk-adjustment in research studies and quality assurance in surgery.
Sections du résumé
BACKGROUND
BACKGROUND
Postoperative pancreatic fistula (POPF) is a major factor for morbidity and mortality after pancreatic resection. Risk stratification for POPF is important for adjustment of treatment, selection of target groups in trials and quality assessment in pancreatic surgery. In this study, we built a risk-prediction model for POPF based on a large number of predictor variables from the German pancreatic surgery registry StuDoQ|Pancreas.
METHODS
METHODS
StuDoQ|Pancreas was searched for patients, who underwent pancreatoduodenectomy from 2014 to 2016. A multivariable logistic regression model with elastic net regularization was built including 66 preoperative und intraoperative parameters. Cross-validation was used to select the optimal model. The model was assessed via area under the ROC curve (AUC) and calibration slope and intercept.
RESULTS
RESULTS
A total of N = 2488 patients were included. In the optimal model the predictors selected were texture of the pancreatic parenchyma (soft versus hard), body mass index, histological diagnosis pancreatic ductal adenocarcinoma and operation time. The AUC was 0.70 (95% CI 0.69-0.70), the calibration slope 1.67 and intercept 1.12. In the validation set the AUC was 0.65 (95% CI 0.64-0.66), calibration slope and intercept were 1.22 and 0.42, respectively.
CONCLUSION
CONCLUSIONS
The model we present is a valid measurement instrument for POPF risk based on four predictor variables. It can be applied in clinical practice as well as for risk-adjustment in research studies and quality assurance in surgery.
Identifiants
pubmed: 30563791
pii: S1424-3903(18)30755-5
doi: 10.1016/j.pan.2018.11.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
17-25Investigateurs
Carsten Crones
(C)
Frank Klammer
(F)
Matthias Anthuber
(M)
Merten Hommann
(M)
Klaus Prenzel
(K)
Johann Pratschke
(J)
Eric P M Lorenz
(EPM)
Waldemar Uhl
(W)
Jörg C Kalff
(JC)
Ute Tröbs
(U)
Helmut Witzigmann
(H)
Hans-Jörg Krämling
(HJ)
Albrecht Stier
(A)
Robert Grützmann
(R)
Marco Niedergethmann
(M)
Matthias Schwarzbach
(M)
Wolf Otto Bechstein
(WO)
Thomas Kraus
(T)
Stefan Fichtner-Feigl
(S)
Michael Kindler
(M)
Thomas Manger
(T)
Winfried Padberg
(W)
Michael Ghadimi
(M)
Karl-Jürgen Oldhafer
(KJ)
Ansgar Michael Chromik
(AM)
Nurettin Albayrak
(N)
Matthias Glanemann
(M)
Christian Mönch
(C)
Hans-Bernd Reith
(HB)
Christiane Bruns
(C)
Anton J Kroesen
(AJ)
Sven Eisold
(S)
Tobias Keck
(T)
Ullrich Fleck
(U)
Stefan Post
(S)
Detlef Bartsch
(D)
Carsten Gutt
(C)
Jens Werner
(J)
Natascha Nüssler
(N)
Helmut Friess
(H)
Norbert Senninger
(N)
Hubert Stein
(H)
Franz-Josef Schumacher
(FJ)
Dietmar Lorenz
(D)
Pompiliu Piso
(P)
Ernst Klar
(E)
Jörg-Peter Ritz
(JP)
Jörg Köninger
(J)
Norbert Runkel
(N)
Elke Wagler
(E)
Christoph Jacobi
(C)
Stefan Farkas
(S)
Mark Jäger
(M)
Christoph-Thomas Germer
(CT)
Informations de copyright
Copyright © 2018. Published by Elsevier B.V.