A simplified scoring system for the prediction of pancreatoduodenectomy's complications: An observational study

Medicine (Baltimore). 2019 Jan;98(1):e13969. doi: 10.1097/MD.0000000000013969.

Abstract

To assess the efficiency of several previous scoring systems in the prediction of postoperative complications of pancreatoduodenectomy (PCPD) and to explore a new simplified scoring system for PCPD prediction.All 183 consecutive patients scheduled for PD from 2010 to 2017 in the Second Affiliated Hospital of Chongqing Medical University were collected retrospectively. The area under the curve (AUC) for the prediction of PCPD was calculated for POSSUM, E-PASS, APACHE-II, and APACHE-III, which were used to test the efficiency of PCPD prediction. The independent risk factors included in the new scoring system were determined by univariate analysis and a logistic regression model. Next, the prediction efficiency was validated.The results of the univariate analysis showed that such variables as male sex, weight, WBC, serum sodium, arterial pH, postoperative 24 hours urine output, and operation time were influence factors for postoperative complications (P <.05). Arterial pH, serum sodium, postoperative 24 hours urine output, and WBC were independent risk factors of postoperative complications based on the logistic regression analysis (P <.05). The AUC of the novel scoring system for PCPD prediction was 85.4%.The proposed scoring system might be a more effective tool for predicting PCPD compared with previous multipurpose scoring systems.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Diseases / pathology
  • Pancreatic Diseases / surgery*
  • Pancreaticoduodenectomy / adverse effects*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / pathology*
  • Predictive Value of Tests
  • Research Design / standards*
  • Retrospective Studies
  • Risk Factors