Value of general surgical risk models for predicting postoperative morbidity and mortality in pancreatic resections for pancreatobiliary carcinomas
Value of general surgical risk models for predicting postoperative morbidity and mortality in pancreatic resections for pancreatobiliary carcinomas
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DOI：
10.1002/jhbp.105
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发表时间：
2014-08-01
影响因子：
3
通讯作者：
Ikenaga, Masakazu
中科院分区：
文献类型：
--
作者：
Haga, Yoshio;Wada, Yasuo;Ikenaga, Masakazu
背景本研究评估了一般外科风险模型在预测胰胆管癌胰腺切除术专业领域的术后发病率和死亡率方面的实用性。方法我们调查了生理能力和手术应激的估计（E-PASS）及其修改版本（mE-PASS），和朴茨茅斯生理和手术严重程度评分的死亡率和发病率的enUmeration（P-POSSUM）在231例接受胰管切除术或胰尾切除术（A组）的患者。我们还分析了E-PASS和mE-PASS在另一个队列中的相同程序（组B，n = 313）。结果在A组中，用于检测院内死亡率的受试者工作特征曲线下面积（AUC）为中度，E-PASS为0.75，mE-PASS为0.69，P-POSSUM为0.69。模型的预测死亡率与术后并发症的严重程度显著相关（对于E-PASS，rho = 0.17，P = 0.011;对于P-POSSUM，rho = 0.15，P = 0.027）。B组的AUC也为中度，E-PASS为0.68，mE-PASS为0.69。预测的死亡率与术后并发症的严重程度显著相关（rho = 0.18，P = 0.0018的E-PASS; rho = 0.17，P = 0.0022的mE-PASS）。结论本研究表明，一般风险模型的预测能力可能是中等的胰腺切除术。这些程序需要一种新的模式。
Background The present study evaluated the utility of general surgical risk models to predict postoperative morbidity and mortality in the specialty field of pancreatic resections for pancreatobiliary carcinomas.Methods We investigated Estimation of PhysiologicAbility and Surgical Stress (E-PASS), its modified version (mE-PASS), and Portsmouth Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in 231 patients undergoing pancreatoduodenectomy or distal pancreatectomy (Group A). We also analyzed E-PASS and mE-PASS in another cohort of the same procedures (Group B, n = 313).Results Areas under the receiver operating characteristic curve (AUC) for detecting in-hospital mortality in Group A were moderate at 0.75 for E-PASS, 0.69 for mE-PASS, and 0.69 for P-POSSUM. The predicted mortality rates of the models significantly correlated with severity of postoperative complications (rho = 0.17, P = 0.011 for E-PASS; rho = 0.15, and P = 0.027 for P-POSSUM). The AUCs were also moderate in Group B at 0.68 for E-PASS and 0.69 for mE-PASS. The predicted mortality rates significantly correlated with severity of postoperative complications (rho = 0.18, P = 0.0018 for E-PASS; rho = 0.17, and P = 0.0022 for mE-PASS).Conclusions The present study suggests that the predictive powers of general risk models may be moderate in pancreatic resections. A novel model would be desirable for these procedures.