Utility of the Surgical Apgar Score in pancreatic cancer and modification
Utility of the Surgical Apgar Score in pancreatic cancer and modification
复制标题
外科阿普加评分在胰腺癌中的实用性和修改
DOI：
10.1016/j.lers.2019.07.004
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发表时间：
2019-12
期刊：
影响因子：
--
通讯作者：
Cao Liping
中科院分区：
文献类型：
--
作者：
Ding Guoping;Zhou Liangjing;Chen Wenchao;Wu Zhengrong;Shen Tao;Cao Liping
目的外科Apgar评分（SAS）可预测不同术野的并发症发生率。然而，很少在胰腺癌中进行研究。本研究的目的是评估SAS在胰腺导管腺癌（PDAC）中的预测价值，并提出一种更适合于胰腺癌patients.Materials和MethodsA前瞻性队列研究160例PDAC患者的结论。主要终点是30天的严重并发症。如所述计算SAS。用受试者工作特征曲线（ROC）和曲线下面积（AUC）分析SAS评分对PDAC主要并发症或死亡的预测能力（p= 0.020，AUC = 0.606），尤其是肺炎（p= 0.022）和胸腔积液（p= 0.023）并发症。此外，SAS对胰体尾切除术组有显著的预测价值，而对胰体尾切除术组的预测价值较弱。在多变量分析中，主要术后并发症的发生与最低平均动脉压、估计失血量和手术时间相关。有趣的是，作为SAS的一个特征，最低心率并不涉及。我们提出的改良SAS包括最低平均动脉压、估计失血量和手术时间，将AUC从0.606提高到0.743。结论SAS是一种简单、快速的评分系统，可有效地预测术后主要并发症。此外，本研究提出的改良SAS，包括最低平均动脉压、估计失血量和手术时间，对PDAC患者有更好的预测价值。
ObjectivesThe Surgical Apgar Score (SAS) can predict the incidence of complications in different surgical fields. However, it is rarely studied in pancreatic cancer. The aim of the present study was to assess the predictive value of the SAS in pancreatic ductal adenocarcinoma (PDAC), and then propose a modified SAS which was more suitable for pancreatic cancer patients.Materials and methodsA prospective cohort study of 160 PDAC patients was concluded. The primary endpoint was 30-day major complications. The SAS was calculated as described. The overall discriminatory power of the score was analyzed using receiver operating characteristic curves and the area under the curve (AUC) with respect to major complications or death.ResultsIt showed a significant predictive value of SAS in major complications or death in PDAC (p= 0.020, AUC = 0.606), especially in complication of pneumonia (p= 0.022) and pleural effusion (p= 0.023). In addition, the SAS exert significant predictive value in distal pancreatectomy group, but it has a weak predictive value for pancreaticoduodenectomy group. On multivariable analyses, occurrence of major postoperative complications was associated with lowest mean arterial pressure, estimated blood loss and operative time. Interestingly, as a characteristic of SAS, lowest heart rate was not involved. The modified SAS we proposed including lowest mean arterial pressure, estimated blood loss and operative time increased AUC from 0.606 to 0.743.ConclusionsThe SAS can be a simple, rapid scoring system that effectively predicts major postoperative complications. Besides, the modified SAS we proposed in this study, which included lowest mean arterial pressure, estimated blood loss and operative time, exert a better predictive value in PDAC patients.
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影响因子：
3.2
作者：
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通讯作者：
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作者：
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影响因子：
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作者：
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通讯作者：
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DOI：
10.4103/2006-8808.185653
发表时间：
2015-07
期刊：
Journal of surgical technique and case report
影响因子：
--
作者：
Munghate A;Kumar A;Mittal S;Singh H;Sharma J;Yadav M
通讯作者：
Yadav M