Validation of original and alternative fistula risk scores in postoperative pancreatic fistula.
Age Distribution
Aged
Databases, Factual
Female
Follow-Up Studies
Humans
Incidence
Japan
Logistic Models
Male
Middle Aged
Pancreatic Fistula
/ diagnostic imaging
Pancreatic Neoplasms
/ mortality
Pancreaticoduodenectomy
/ adverse effects
Postoperative Complications
/ diagnosis
ROC Curve
Reoperation
/ methods
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Distribution
Treatment Outcome
Fistula risk score
Pancreaticoduodenectomy
Postoperative pancreatic fistula
Risk factor
Validation
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
pubmed:
28
5
2019
medline:
29
1
2020
entrez:
25
5
2019
Statut:
ppublish
Résumé
In 2013, the fistula risk score (FRS) was developed to assess the risk of clinically relevant postoperative pancreatic fistula (CR-POPF). In 2017, the alternative FRS (a-FRS) was proposed. The purpose of this study was to validate the original FRS (o-FRS) and a-FRS for CR-POPF in pancreaticoduodenectomy (PD). From January 2007 to December 2016, 1,771 patients underwent PD for periampullary cancers. POPF was defined and classified according to the 2016 International Study Group for Pancreatic Fistula. All data were reviewed retrospectively. Pathologic diagnosis other than ductal adenocarcinoma (P < 0.001), pancreas duct diameter (P < 0.001), and body mass index (P < 0.001) were independent risk factors for CR-POPF. Pancreatic texture (P = 0.534) and estimated blood loss (P = 0.827) were not associated with CR-POPF. The CR-POPF incidence increased with increasing o-FRS score (P < 0.001), and also increased statistically significantly with increasing a-FRS in the higher risk group (P < 0.001). However, the correlations differed. The area under the curve was 0.629 for o-FRS and 0.622 for a-FRS. Both o-FRS and a-FRS might reflect CR-POPF incidence, but some risk factors had no or low statistical significance. Further research is needed to revise the FRS.
Sections du résumé
BACKGROUND
BACKGROUND
In 2013, the fistula risk score (FRS) was developed to assess the risk of clinically relevant postoperative pancreatic fistula (CR-POPF). In 2017, the alternative FRS (a-FRS) was proposed. The purpose of this study was to validate the original FRS (o-FRS) and a-FRS for CR-POPF in pancreaticoduodenectomy (PD).
METHODS
METHODS
From January 2007 to December 2016, 1,771 patients underwent PD for periampullary cancers. POPF was defined and classified according to the 2016 International Study Group for Pancreatic Fistula. All data were reviewed retrospectively.
RESULTS
RESULTS
Pathologic diagnosis other than ductal adenocarcinoma (P < 0.001), pancreas duct diameter (P < 0.001), and body mass index (P < 0.001) were independent risk factors for CR-POPF. Pancreatic texture (P = 0.534) and estimated blood loss (P = 0.827) were not associated with CR-POPF. The CR-POPF incidence increased with increasing o-FRS score (P < 0.001), and also increased statistically significantly with increasing a-FRS in the higher risk group (P < 0.001). However, the correlations differed. The area under the curve was 0.629 for o-FRS and 0.622 for a-FRS.
CONCLUSIONS
CONCLUSIONS
Both o-FRS and a-FRS might reflect CR-POPF incidence, but some risk factors had no or low statistical significance. Further research is needed to revise the FRS.
Identifiants
pubmed: 31125494
doi: 10.1002/jhbp.638
pmc: PMC6771591
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
354-359Informations de copyright
© 2019 The Authors. Journal of Hepato-Biliary-Pancreatic Sciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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