Publications

Authors:

Mungroop, Th; van Rijssen, Lb; van Klaveren, D; Smits, Fj; van Woerden, V; Linnemann, Rj; de Pastena, M; Klompmaker, S; Marchegiani, G; Ecker, Bl; van Dieren, S; Bonsing, B; Busch, Or; van Dam, Rm; Erdmann, J; van Eijck, Ch; Gerhards, Me; van Goor, H; van der Harst, E; de Hingh, Ih; de Jong, Kp; Kazemier, G; Luyer, M; Shamali, A; Barbaro, S; Armstrong, T; Takhar, A; Hamady, Z; Klaase, J; Lips, Dj; Molenaar, Iq; Nieuwenhuijs, Vb; Rupert, C; van Santvoort, Hc; Scheepers, Jj; van der Schelling, Gp; Bassi, C; Vollmer, Cm; Steyerberg, Ew; Abu Hilal, M; Koerkamp, Bg; Besselink, Mg

Title:

Alternative Fistula Risk Score for Pancreatoduodenectomy (a-FRS) Design and International External Validation

Year:

2019

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Annals of Surgery

ISSN of journal:

0003-4932

N° Volume:

269

Number or Folder:

5

Page numbers:

937-943

Keyword:

complication; pancreas; pancreatic fistula; prediction model; Aged; Female; Humans; Internationality; Male; Middle Aged; Pancreatic Fistula; Postoperative Complications; Risk Assessment; Pancreaticoduodenectomy

Short description of contents:

Objective: The aim of this study was to develop an alternative fistula risk score (a-FRS) for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, without blood loss as a predictor.Background: Blood loss, one of the predictors of the original-FRS, was not a significant factor during 2 recent external validations.Methods: The a-FRS was developed in 2 databases: the Dutch Pancreatic Cancer Audit (18 centers) and the University Hospital Southampton NHS. Primary outcome was grade B/C POPF according to the 2005 International Study Group on Pancreatic Surgery (ISGPS) definition. The score was externally validated in 2 independent databases (University Hospital of Verona and University Hospital of Pennsylvania), using both 2005 and 2016 ISGPS definitions. The a-FRS was also compared with the original-FRS.Results: For model design, 1924 patients were included of whom 12% developed POPE Three predictors were strongly associated with POPF: soft pancreatic texture [odds ratio (OR) 2.58, 95% confidence interval (95% CI) 1.80-3.69], small pancreatic duct diameter (per mm increase, OR: 0.68, 95% CI: 0.61-0.76), and high body mass index (BMI) (per kg/m(2) increase, OR: 1.07, 95% CI: 1.04-1.11). Discrimination was adequate with an area under curve (AUC) of 0.75 (95% CI: 0.71-0.78) after internal validation, and 0.78 (0.74-0.82) after external validation. The predictive capacity of a-FRS was comparable with the original-FRS, both for the 2005 definition (AUC 0.78 vs 0.75, P = 0.03), and 2016 definition (AUC 0.72 vs 0.70, P = 0.05).Conclusion: The a-FRS predicts POPF after pancreatoduodenectomy based on 3 easily available variables (pancreatic texture, duct diameter, BMI) without blood loss and pathology, and was successfully validated for both the 2005 and 2016 POPF definition. The online calculator is available at www.pancreascalculator.com .

Product ID:

118263

Handle IRIS:

11562/1031979

Last Modified:

November 15, 2022

Bibliographic citation:

Mungroop, Th; van Rijssen, Lb; van Klaveren, D; Smits, Fj; van Woerden, V; Linnemann, Rj; de Pastena, M; Klompmaker, S; Marchegiani, G; Ecker, Bl; van Dieren, S; Bonsing, B; Busch, Or; van Dam, Rm; Erdmann, J; van Eijck, Ch; Gerhards, Me; van Goor, H; van der Harst, E; de Hingh, Ih; de Jong, Kp; Kazemier, G; Luyer, M; Shamali, A; Barbaro, S; Armstrong, T; Takhar, A; Hamady, Z; Klaase, J; Lips, Dj; Molenaar, Iq; Nieuwenhuijs, Vb; Rupert, C; van Santvoort, Hc; Scheepers, Jj; van der Schelling, Gp; Bassi, C; Vollmer, Cm; Steyerberg, Ew; Abu Hilal, M; Koerkamp, Bg; Besselink, Mg, Alternative Fistula Risk Score for Pancreatoduodenectomy (a-FRS) Design and International External Validation «Annals of Surgery» , vol. 269 , n. 5 , 2019 , pp. 937-943

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