Personal predictive model based on systemic inflammation markers for estimation of postoperative pancreatic fistula following pancreaticoduodenectomy

Long, Zhi-Da; Lu, Chao; Xia, Xin; Chen, Bin; Xing, Zhixiang; Bie, Lei; Zhou, Peng; Ma, Zhong-Lin; Wang, Rui

doi:10.4240/wjgs.v14.i9.963

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…Recently, inflammatory and nutritional status markers measured using parameters, such as the Controlled Nutritional Status (CONUT) score, have been shown to be successful in predicting poor prognosis in various diseases [ 12 , 13 ]. These inflammatory and nutritional status parameters are based on serum and/or peripheral blood counts and are easily measured in daily clinical practice [ 14 , 15 ].…”

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confidence: 99%

Comparison of Controlling Nutritional Status Score with Bedside Index for Severity in Acute Pancreatitis Score and Atlanta Classification for Mortality in Patients with Acute Pancreatitis

Çavuşoğlu Türker,

Ahbab,

Türker

et al. 2024

JCM

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Background/Objectives: Acute pancreatitis (AP) is characterized by pancreatic gland inflammation, and its clinical course ranges from mild to severe. Predicting the severity of AP early and reliably is important. In this study, we investigate the potential use of the Controlling Nutritional Status (CONUT) score as a prognostic marker in acute pancreatitis. Methods: We examined 336 patients who had been hospitalized with an AP diagnosis in the internal medicine clinic. The patients included in the study were followed up for 5 years. The study analyzed the specific variables of age, gender, and AP etiology as recorded biochemical parameters for all study participants and calculated the effects of age, sex, Bedside Index of Severity in AP (BISAP), the revised Atlanta classification, and the CONUT score on mortality. Results: When compared with surviving patients, non-surviving patients had higher scores for BISAP, CONUT, and the Atlanta Classification (p ˂ 0.001). In the non-surviving group, hemoglobin, lymphocyte, and albumin levels were significantly lower and creatinine, uric acid, and procalcitonin levels were significantly higher compared to the surviving group (p ˂ 0.001, 0.003, ˂0.001, ˂0.001, 0.005, ˂0.001, respectively). The multivariate analysis showed a significant association of mortality with age, CONUT, and BISAP scores (p ˂ 0.003, 0.001, 0.012 respectively). The CONUT score was separated into two groups based on the median value. The predicted survival time in the group with a CONUT score > 2 (53.8 months) was significantly lower than in the group with a CONUT score ≤ 2 (63.8 months). The cumulative incidence of all-cause mortality was significantly higher in the patients with higher CONUT scores. Conclusions: This study has assigned the CONUT score as an independent risk factor for mortality in AP.

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Section: Introductionmentioning

confidence: 99%

Comparison of Controlling Nutritional Status Score with Bedside Index for Severity in Acute Pancreatitis Score and Atlanta Classification for Mortality in Patients with Acute Pancreatitis

Çavuşoğlu Türker,

Ahbab,

Türker

et al. 2024

JCM

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A Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis analysis to evaluate the quality of reporting of postoperative pancreatic fistula prediction models after pancreatoduodenectomy: A systematic review

Alhulaili,

Linnemann,

Dascau

et al. 2023

Surgery

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A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers

Yang,

Zhang,

Tan

2024

Preprint

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1.1Objective According to relevant studies, the incidence of pancreatic tumors has increased in both Asian and Western countries [1]. Surgical resection is the cornerstone of treatment for this aggressive disease [2] [3]. According to relevant studies, postoperative pancreatic fistula (POPF) in pancreatic tumors is one of the most serious complications after surgery, which seriously affects the course of patients' treatment and their prognosis [2] [3]. In the present study, we aime to identify the risk factors associated with clinically relevant postoperative pancreatic fistula (CR-POPF) based on systemic inflammatory markers (SIB), and preoperative, intraoperative, and postoperative dimensions, and to establish a multidimensional columnar graphical model for predicting postoperative pancreatic fistula (POPF) in pancreatic tumors [4] [5]. 1.2Methods Ninety patients who underwent surgery for pancreatic tumors at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Dalian Medical University between November 21, 2022 and November 21, 2023 were retrospectively studied. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University, and the relevant guidelines and regulations have been strictly followed.The collected clinical data were first processed by feature engineering and analyzed with relevant statistics such as chi-square test according to the criteria described in the Supplementary file, and risk factors with P-Value ≤ 0.05were selected. Then, the data set was randomly divided into training set and validation set according to 7:3, and then batch one-way logistic regression analysis was performed and risk factors with P-Value ≤ 0.05 were selected, and then multifactorial logistic regression analysis was performed and the optimal multivariate regression model was constructed. Based on the results of multifactors logistic regression analysis, a multidimensional column-line diagram was developed . The Bootstrap method was used to validate the model in a relevant way, and the predictive performance was assessed using the subject work characteristics (ROC) curve, and the clinical application value of the model was verified using the decision curve analysis (DCA) and calibration (Calibration) curve. 1.3Results The incidence of POPF in this study was 50.0% (45/90). Multivariate logistic regression analysis identified the following variables as independent risk factors for POPF: preoperative albumin level(ALB, OR:5.06,P=0.012), neutrophil to lymphocyte ratio (NLR, OR: 9.55,P < 0.001), and systemic immunoinflammatory markers (SII, OR: 0.006,P =4.58), the ratio of amylase concentration in drainage fluid to preoperative blood amylase concentration (DSAR, OR=26.73,P < 0.001). We create a multi-dimensional nomogram by combining the above risk factors. The multidimensional nomogram model shows better predictive value. AUC under receiver Operating characteristic (ROC) curve: training set AUC=0.889 > 0.50, validation set AUC=0.949 > 0.50. The results show that the multidimensional nomogram model has good predictive performance, and the DCA and Calibration analyses of training set and validation set also show that the multidimensional nomogram model has higher clinical net benefit and better fit. 1.4Conclusion Based on SIB, the column diagram we constructed can scientifically, accurately and objectively predict the risk of POPF in patients after pancreatic tumor surgery, which can better assist clinicians to conduct scientific POPF risk assessment on patients about to undergo pancreatic tumor surgery, and timely conduct relevant clinical intervention, so as to better develop the mitigation strategy of pancreatic fistula and corresponding postoperative management. The quality of life and prognosis of patients after operation were improved.

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Personal predictive model based on systemic inflammation markers for estimation of postoperative pancreatic fistula following pancreaticoduodenectomy

Cited by 4 publications

References 33 publications

Comparison of Controlling Nutritional Status Score with Bedside Index for Severity in Acute Pancreatitis Score and Atlanta Classification for Mortality in Patients with Acute Pancreatitis

Comparison of Controlling Nutritional Status Score with Bedside Index for Severity in Acute Pancreatitis Score and Atlanta Classification for Mortality in Patients with Acute Pancreatitis

A Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis analysis to evaluate the quality of reporting of postoperative pancreatic fistula prediction models after pancreatoduodenectomy: A systematic review

A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers

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