胰周癌胰十二指肠切除术后临床相关胰瘘的风险因素和提名图:前瞻性多中心队列研究

IF 0.2 Q4 SURGERY
Trường Quốc Võ, Minh Tri Phan, Cong Duy Long Tran, Tien My Doan
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引用次数: 0

摘要

临床相关的术后胰瘘(CRPF)被认为是胰十二指肠切除术(PD)相关的最危险的发病率。本研究旨在评估胰十二指肠切除术后 CRPF 的风险因素并构建预测模型。 这项多中心队列研究纳入了2021年8月至2023年10月期间在赵雷医院和大学医学中心接受胰十二指肠切除术的连续患者。通过多变量逻辑回归分析确定了CRPF的风险因素,并根据这些因素建立了一个提名图。利用接收者操作特征曲线下面积(ROC)评估了提名图在预测 CRPF 方面的价值。 本研究共有 183 名符合条件的患者(平均年龄:57.5 ± 12.6 岁;101 名男性),CRPF 患病率为 13.7%。多变量分析表明,术前血清白蛋白<3.5 g/dl、体重指数(BMI)≥25 kg/m2、胰腺质地较软和估计失血量≥400 ml这四个与CRPF相关的风险因素是CRPF的预后因素(P < 0.05)。我们根据四个变量建立了一个预测 CRPF 的提名图,该提名图的 ROC 曲线下面积为 0.855(95% CI:0,768 - 0,933)。 根据四个风险因素绘制的提名图在预测腹膜透析后 CRPF 方面表现良好。本研究的临床发现将有助于外科医生确定胰瘘高危患者的围手术期风险因素,这些患者的管理方式应与其他患者不同。 临床试验注册号: 临床试验登记号:ClinicalTrials.gov NCT05017207。 我们成功开发了一种提名图,利用四个围手术期因素预测胰瘘风险。通过将这些风险因素纳入临床实践,外科医生可以为高风险患者群体制定适当的治疗计划和干预措施,从而降低与 CRPF 相关的发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors and nomogram of clinically relevant pancreatic fistula after pancreaticoduodenectomy for periampullary cancer: A prospective multicenter cohort study
Clinically relevant postoperative pancreatic fistula (CRPF) is considered the most dangerous morbidity associated with pancreaticoduodenectomy (PD). The purpose of this study is to evaluate the risk factors and to construct a predicted model for CRPF after PD. Consecutive patients who underwent pancreaticoduodenectomy between August 2021 and October 2023 at Cho Ray Hospital and University Medical Center were included in a multicenter cohort research. Multivariate logistic regression analyses was used to identify the risk factors of CRPF, and a nomogram was built based on these factors. The value of the nomogram in predicting CRPF was evaluated using the area under the receiver operating characteristic (ROC) curve. There were 183 eligible patients in this study (mean age: 57.5 ± 12.6 years; 101 males), and the prevalence of CRPF was 13,7% overall. Multivariate analyses showed that, four risk factors related to CRPF, including preoperative serum albumin <3.5 g/dl, body mass index (BMI) ≥ 25 kg/m2, soft texture of the pancreas and estimated blood loss ≥400 ml were prognostic factors for CRPF (p < 0.05). We built a nomogram based on four variables to predict CRPF, and the area under the ROC curve for this nomogram was 0.855 (95% CI: 0,768 – 0,933). Nomogram developed from four risk factors shows good performance to predict CRPF after PD. The clinical findings of this study will help surgeons identify perioperative risk factors for high-risk patients with pancreatic fistula who should be managed differently from other patients. Clinical Trial Registry number: ClinicalTrials.gov NCT05017207. We successfully developed a nomogram to predict the risk of pancreatic fistula using four perioperative factors. By incorporating these risk factors into clinical practice, surgeons can develop appropriate treatment plans and interventions for high-risk patient populations, potentially reducing the morbidity associated with CRPF.
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
11 weeks
期刊介绍: Formosan Journal of Surgery, a publication of Taiwan Surgical Association, is a peer-reviewed online journal with Bimonthly print on demand compilation of issues published. The journal’s full text is available online at http://www.e-fjs.org. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository.
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