Conti Bellocchi Maria Cristina, Crinò Stefano Francesco, Fioravante Marzia, Gabrieletto Enrico Maria, Di Stefano Serena, Bernardoni Laura, Gkolfakis Paraskevas, Ofosu Andrew, Facciorusso Antonio, Gabbrielli Armando
Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy.
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Expert Rev Gastroenterol Hepatol. 2022 Apr;16(4):393-399. doi: 10.1080/17474124.2022.2056445. Epub 2022 Mar 23.
To develop and validate a risk score for predicting clinical success after duodenal stenting using self-expanding metallic stents (SEMS) for malignant gastric outlet obstruction (GOO).
Consecutive patients who underwent duodenal stenting for malignant GOO were evaluated. Potential predictors of clinical success were determined by uni/multivariate logistic regression analysis.Multiplication of the regression coefficients of the logistic regression model by a factor of two and rounding to obtain easy-to-use point numbers enabling the calculation of the score. Using 10-fold cross-validation, the model was internally validated.
One hundred twelve patients were included. Clinical success was achieved in 93 (83.0%) patients. On multivariate logistic regression, selected age ≤65 years (p = 0.05, 1.5 points), stenosis type I (p = 0.04, 3 points), and pancreatic cancer (p = 0.01, 3.5 points) were significant predictors of clinical success. On the Receiver Operating Characteristic (ROC) analysis, a score of 5 had higher specificity and sensitivity.
Our score could be useful at identifying, among poor surgical candidates, patients more likely to benefit from SEMS.
开发并验证一种风险评分，用于预测使用自膨式金属支架（SEMS）治疗恶性胃出口梗阻（GOO）后十二指肠支架置入术的临床成功率。
对连续接受十二指肠支架置入术治疗恶性GOO的患者进行评估。通过单因素/多因素逻辑回归分析确定临床成功的潜在预测因素。将逻辑回归模型的回归系数乘以2并四舍五入，以获得便于计算评分的易用点数。使用10折交叉验证对模型进行内部验证。
纳入112例患者。93例（83.0%）患者获得临床成功。在多因素逻辑回归分析中，年龄≤65岁（p = 0.05，1.5分）、I型狭窄（p = 0.04, 3分）和胰腺癌（p = 0.01, 3.5分）是临床成功的显著预测因素。在受试者工作特征（ROC）分析中，评分为5时具有更高的特异性和敏感性。
我们的评分有助于在手术不佳的候选患者中识别更可能从SEMS中获益的患者。
