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HPB (Oxford). 2017 Jun;19(6):508-514. doi: 10.1016/j.hpb.2017.01.021. Epub 2017 Feb 21.

Validation of Fistula Risk Score calculator in diverse North American HPB practices.

Author information

1
Providence Portland Medical Center, Portland, OR, USA.
2
Stanford Medical Center, Stanford University, Stanford, CA, USA.
3
Foothills Medical Center, University of Calgary, Calgary, AB, Canada.
4
Virginia Mason Medical Center, Seattle, WA, USA.
5
Providence Portland Medical Center, Portland, OR, USA. Electronic address: phansen@orclinic.com.

Abstract

BACKGROUND:

Fistula Risk Score (FRS) is a previously developed tool to assess the risk of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreatoduodenectomy (PD).

METHODS:

Prospectively collected databases from 4 university affiliated and non-affiliated HPB centers in United States and Canada were used. The influence of individual baseline characteristics, FRS and FRS group on CR-POPF was assessed in univariate and multivariate analyses. FRS calculator performance was assessed using a C-statistic.

RESULTS:

444 patients were identified. Pathology, soft pancreas texture and pancreatic duct size were associated with CR-POPF rates (p < 0.001 for each); EBL was not (p = 0.067). The negligible risk group consisted of 50 (11.3%) patients, low risk of 118 (26.6%), moderate 234 (52.7%) and high risk group of 42 (9.5%) patients. The overall rate of CR-POPF was 20%. Of the patients in the negligible risk group, 2% developed CR-POPF, 13.6% of the low risk, 23.1% moderate and 42.9% in the high risk group (p < 0.001). Overall C-statistic was 0.719.

CONCLUSION:

FRS is robust and able to stratify the risk of developing CR-POPF following PD in diverse North American academic and non-academic institutions. The FRS should be used in research and to guide clinical management of patients post PD in these institutions.

PMID:
28233672
DOI:
10.1016/j.hpb.2017.01.021
[Indexed for MEDLINE]
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