胰十二指肠切除术后胰瘘的术前预测：罗伯茨评分临界值的确定和验证

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-04-25 DOI:10.1016/j.amjsurg.2025.116356

Johannes D. Kaiser, Franziska Bräuherr, Esther A. Biesel, Sophia Chikhladze, Stefan Fichtner-Feigl, Dietrich A. Ruess , Uwe A. Wittel

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引用次数: 0

摘要

背景：胰十二指肠切除术后的popf可能危及生命。对于风险分层，预测可能是关键。本研究的目的是确定并验证罗伯茨评分的临界值，罗伯茨评分是为数不多的单纯术前多中心验证的POPF预测模型之一。方法纳入患者s582例。约登指数确定了探索性队列的截止值（n = 466）。采用单变量和多变量回归分析对验证队列（n = 116）预测CR-POPF的能力进行检验。结果探索队列的Roberts Score的auc为0.768。在验证队列中确认了0.268的临界值(p <；0.001)。得分越高，拔管时间越长，ICU住院时间越长。多元逻辑回归显示截止值是CR-POPF的独立预测因子（p = 0.038）。结论评分变量和截止值本身都是独立的预测因子，可以提高对高危患者的识别，有助于研究POPF的发展。

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Preoperative prediction of postoperative pancreatic fistula after Pancreaticoduodenectomy: Determination and validation of a cut-off value for the Roberts Score

Background

POPF after pancreaticoduodenectomy can be life-threatening. For risk stratification, prediction could be key. The aim of this study is to determine and validate a cut-off value for the Roberts Score, which is one of the few purely preoperative multicenter validated predictive models for POPF.

Methods

582 patients were included. The Youden index determined a cut-off in the exploratory cohort (n = 466). The validation cohort's (n = 116) ability to predict CR-POPF was tested using univariate and multivariate regression analysis.

Results

AUC of Roberts Score for the exploration cohort was 0.768. The identified cut-off of 0.268 was confirmed in the validation cohort (p < 0.001). Higher scores were significantly associated with longer time to drain removal and ICU stay. Multiple logistic regression showed the cut-off as an independent predictor of CR-POPF (p = 0.038).

Conclusion

The scoring variables and the cut-off itself were both independent predictors, which may improve the identification of high-risk patients and help to investigate the development of POPF.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.