Development of a Novel Pancreatoduodenectomy-Specific Risk Calculator: an Analysis of 10,000 Patients.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Amr I Al AbbasAmer H Zureikat

Abstract

Pancreatoduodenectomy (PD) is often performed in frail patients and is associated with significant morbidity. The five-factor modified frailty index (mFI-5) has been utilized to predict adverse postoperative outcomes, but has not been tested in PD. We aimed to develop risk tools to generate and predict 30-day outcomes after PD and compare their performance with the mFI-5. Risk tools were then used to generate a PD-specific calculator. Elective PDs from the 2014-2016 ACS NSQIP® Procedure Targeted Pancreatectomy PUFs were identified. Multivariable logistic regression models were constructed to predict postoperative mortality, any complication, serious complication, clinically relevant postoperative pancreatic fistula (CR-POPF), and discharge not-to-home. Predictive accuracy was evaluated through repeated stratified tenfold cross-validation and compared to the mFI-5. Nine thousand eight hundred sixty-seven PDs were captured. Nine risk factors were retained: sex, age, BMI, DM, HTN, ASA classification, pancreatic duct size, gland texture, and adenocarcinoma. Cross-validated C-indices ranged from 0.49 to 0.61 for the mFI-5 and 0.63 to 0.75 for our risk models. The best-performing model was for discharge not-to-home (C = 0.75), and th...Continue Reading

References

Dec 3, 2003·The New England Journal of Medicine·John D BirkmeyerF Lee Lucas
May 17, 2006·Surgery·Fabrice MuscariUNKNOWN French Associations for Surgical Research
Dec 7, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Michael G HousePeter J Allen
Mar 30, 2010·Journal of the American College of Surgeons·Carrie K ChuDavid A Kooby
Sep 8, 2010·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Purvi ParikhHenry A Pitt
Feb 22, 2011·Annals of Surgical Oncology·David Yu GreenblattSharon M Weber
Nov 6, 2012·Journal of the American College of Surgeons·Mark P CalleryCharles M Vollmer
Jul 23, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Abhishek D ParmarTaylor S Riall
Sep 5, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Benjamin C MillerCharles M Vollmer
Dec 4, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Laura M EnomotoChristopher S Hollenbeak
Jun 18, 2015·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Trientje B SantemaDirk T Ubbink
Dec 13, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Brian M CusworthWilliam G Hawkins
Mar 28, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Andrea L JesterEugene P Ceppa
May 12, 2017·Surgical Endoscopy·Ioannis T KonstantinidisLaleh G Melstrom
Nov 21, 2017·Journal of the American College of Surgeons·Sneha SubramaniamCelia M Divino
Jan 15, 2018·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Jason WangLaurence Weinberg

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