@article{HBSN25110,
author = {Jae Seung Kang and Taesung Park and Youngmin Han and Seungyeon Lee and Jae Ri Kim and Hongbeom Kim and Wooil Kwon and Sun-Whe Kim and Jin Seok Heo and Seong Ho Choi and Dong Wook Choi and Song Cheol Kim and Tae Ho Hong and Dong Sup Yoon and Joon Seong Park and Sang Jae Park and Sung-Sik Han and Sae-Byeol Choi and Joo Seop Kim and Chang-Sup Lim and Jin-Young Jang},
title = {Clinical validation of scoring systems of postoperative pancreatic fistula after pancreatoduodenectomy: applicability to Eastern cohorts?},
journal = {Hepatobiliary Surgery and Nutrition},
volume = {8},
number = {3},
year = {2019},
keywords = {},
abstract = {Background: Although several prediction models for the occurrence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) exist, all were established using Western cohorts. Large-scale external validation studies in Eastern cohorts that consider demographic variables including lower body mass index (BMI) are scarce. The purpose of this study was to externally validate POPF prediction models using nationwide large-scale Korean cohorts.
Methods: Nine tertiary university hospitals in the Republic of Korea participated. Patients’ preoperative characteristics, intraoperative factors, and pathologic findings were evaluated. POPF grades were determined according to the 2016 International Study Group on Pancreatic Surgery definition. Three POPF risk models (Callery, Roberts, and Mungroop) were selected for external validation.
Results: A total of 1,898 PD patients were enrolled. A non-pancreatic disease diagnosis [hazard ratio (HR), 1.856; 95% confidence interval (CI), 1.223–2.817; P=0.004), higher preoperative BMI (HR, 1.069; 95% CI, 1.019–1.121; P=0.006), and soft pancreatic texture (HR, 1.859; 95% CI, 1.264–2.735; P=0.002) were independent risk factors for clinically relevant POPF (CR-POPF). The area under the receiver operating characteristic curve (AUC) values were 0.61, 0.64, and 0.63 on the Callery, Roberts, and Mungroop models, respectively; all were lower than those published in each external validation study.
Conclusions: Western POPF prediction models performed less well when applied to Korean cohorts. Thus, a large-scale Eastern-specific and externally validated POPF prediction model is needed.},
issn = {2304-389X}, url = {https://hbsn.amegroups.org/article/view/25110}
}