Kaiser Johannes D, Bräuherr Franziska, Biesel Esther A, Chikhladze Sophia, Fichtner-Feigl Stefan, Ruess Dietrich A, Wittel Uwe A
Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Am J Surg. 2025 Jul;245:116356. doi: 10.1016/j.amjsurg.2025.116356. Epub 2025 Apr 25.
POPF after pancreaticoduodenectomy can be life-threatening. For risk stratification, prediction could be key. The aim of this study is to determine and validate a cut-off value for the Roberts Score, which is one of the few purely preoperative multicenter validated predictive models for POPF.
582 patients were included. The Youden index determined a cut-off in the exploratory cohort (n = 466). The validation cohort's (n = 116) ability to predict CR-POPF was tested using univariate and multivariate regression analysis.
AUC of Roberts Score for the exploration cohort was 0.768. The identified cut-off of 0.268 was confirmed in the validation cohort (p < 0.001). Higher scores were significantly associated with longer time to drain removal and ICU stay. Multiple logistic regression showed the cut-off as an independent predictor of CR-POPF (p = 0.038).
The scoring variables and the cut-off itself were both independent predictors, which may improve the identification of high-risk patients and help to investigate the development of POPF.
胰十二指肠切除术后胰瘘可能危及生命。对于风险分层而言，预测可能是关键。本研究的目的是确定并验证罗伯茨评分的临界值，该评分是少数几个经多中心验证的纯术前胰瘘预测模型之一。
纳入582例患者。约登指数在探索性队列（n = 466）中确定了一个临界值。使用单变量和多变量回归分析测试验证队列（n = 116）预测临床相关胰瘘的能力。
探索性队列中罗伯茨评分的AUC为0.768。在验证队列中确认的0.268临界值（p < 0.001）。较高的评分与拔除引流管的时间延长和入住重症监护病房的时间显著相关。多因素逻辑回归显示该临界值是临床相关胰瘘的独立预测因素（p = 0.038）。
评分变量和临界值本身均为独立预测因素，这可能有助于提高对高危患者的识别，并有助于研究胰瘘的发生发展。
