External validation of the NUn score for predicting anastomotic leakage after oesophageal resection

Sci Rep. 2017 Aug 29;7(1):9725. doi: 10.1038/s41598-017-10084-9.

Abstract

Early detection of anastomotic leakage (AL) after oesophageal resection for malignancy is crucial. This retrospective study validates a risk score, predicting AL, which includes C-reactive protein, albumin and white cell count in patients undergoing oesophageal resection between 2003 and 2014. For validation of the NUn score a receiver operating characteristic (ROC) curve is estimated. Area under the ROC curve (AUC) is reported with 95% confidence interval (CI). Among 258 patients (79.5% male) 32 patients showed signs of anastomotic leakage (12.4%). NUn score in our data has a median of 9.3 (range 6.2-17.6). The odds ratio for AL was 1.31 (CI 1.03-1.67; p = 0.028). AUC for AL was 0.59 (CI 0.47-0.72). Using the original cutoff value of 10, the sensitivity was 45.2% an the specificity was 73.8%. This results in a positive predictive value of 19.4% and a negative predictive value of 90.6%. The proportion of variation in AL occurrence, which is explained by the NUn score, was 2.5% (PEV = 0.025). This study provides evidence for an external validation of a simple risk score for AL after oesophageal resection. In this cohort, the NUn score is not useful due to its poor discrimination.

MeSH terms

  • Aged
  • Anastomotic Leak / diagnosis*
  • Anastomotic Leak / etiology*
  • Biomarkers
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / surgery
  • Esophagectomy / adverse effects*
  • Esophagectomy / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morbidity
  • Prognosis
  • ROC Curve
  • Severity of Illness Index

Substances

  • Biomarkers