Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy
Abstract Background Postoperative pancreatic fistula (POPF) is a life-threatening postoperative complication. The aim of this study was to evaluate the efficacy of the fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant POPF (CR-POP...
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doaj-29b5791374e54661a5463206864506d22020-11-25T03:12:01ZengBMCBMC Gastroenterology1471-230X2020-08-012011610.1186/s12876-020-01397-7Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomyTomoyuki Abe0Hironobu Amano1Tsuyoshi Kobayashi2Keiji Hanada3Minoru Hattori4Masahiro Nakahara5Hideki Ohdan6Toshio Noriyuki7Department of Surgery, Onomichi General HospitalDepartment of Surgery, Onomichi General HospitalDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Gastroenterology, Onomichi General HospitalAdvanced Medical Skills Training Center, Institute of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Surgery, Onomichi General HospitalDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Surgery, Onomichi General HospitalAbstract Background Postoperative pancreatic fistula (POPF) is a life-threatening postoperative complication. The aim of this study was to evaluate the efficacy of the fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant POPF (CR-POPF) after pancreaticoduodenectomy (PD). Methods In this study, 136 consecutive patients who underwent PD between 2006 and 2018 were enrolled. The risk factors of CR-POPF (grades B and C) were analyzed. Preoperative visceral adipose tissue area (VATA), skeletal mass index (SMI), and subcutaneous adipose tissue area (SATA) were calculated from computed tomography data. Results The overall 30-day mortality and morbidity rates were 0.7 and 38%, respectively. The incidence rates of grade B and C CR-POPF were 27 and 4%, respectively. A univariate analysis revealed that male sex, habitual smoking, prognostic nutritional index (PNI) < 45, VATA ≥90, VATA/SATA ≥0.9, VATA/SMI ≥ 1.4, and FRS > 4 were significantly associated with the incidence of CR-POPF. A multivariate analysis revealed that PNI < 45, VATA/SMI ≥ 1.4 and FRS > 4 were the independent risk factors of CR-POPF. Conclusions Preoperative anthropomorphic imbalance, PNI, and FRS were independent risk factors for CR-POPF. Patients with high-risk factors should be closely monitored during the postoperative period.http://link.springer.com/article/10.1186/s12876-020-01397-7Fistula risk scorePancreaticoduodenectomyPostoperative pancreatic fistulaSkeletal muscle indexVisceral adipose tissue area |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tomoyuki Abe Hironobu Amano Tsuyoshi Kobayashi Keiji Hanada Minoru Hattori Masahiro Nakahara Hideki Ohdan Toshio Noriyuki |
spellingShingle |
Tomoyuki Abe Hironobu Amano Tsuyoshi Kobayashi Keiji Hanada Minoru Hattori Masahiro Nakahara Hideki Ohdan Toshio Noriyuki Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy BMC Gastroenterology Fistula risk score Pancreaticoduodenectomy Postoperative pancreatic fistula Skeletal muscle index Visceral adipose tissue area |
author_facet |
Tomoyuki Abe Hironobu Amano Tsuyoshi Kobayashi Keiji Hanada Minoru Hattori Masahiro Nakahara Hideki Ohdan Toshio Noriyuki |
author_sort |
Tomoyuki Abe |
title |
Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy |
title_short |
Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy |
title_full |
Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy |
title_fullStr |
Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy |
title_full_unstemmed |
Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy |
title_sort |
preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy |
publisher |
BMC |
series |
BMC Gastroenterology |
issn |
1471-230X |
publishDate |
2020-08-01 |
description |
Abstract Background Postoperative pancreatic fistula (POPF) is a life-threatening postoperative complication. The aim of this study was to evaluate the efficacy of the fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant POPF (CR-POPF) after pancreaticoduodenectomy (PD). Methods In this study, 136 consecutive patients who underwent PD between 2006 and 2018 were enrolled. The risk factors of CR-POPF (grades B and C) were analyzed. Preoperative visceral adipose tissue area (VATA), skeletal mass index (SMI), and subcutaneous adipose tissue area (SATA) were calculated from computed tomography data. Results The overall 30-day mortality and morbidity rates were 0.7 and 38%, respectively. The incidence rates of grade B and C CR-POPF were 27 and 4%, respectively. A univariate analysis revealed that male sex, habitual smoking, prognostic nutritional index (PNI) < 45, VATA ≥90, VATA/SATA ≥0.9, VATA/SMI ≥ 1.4, and FRS > 4 were significantly associated with the incidence of CR-POPF. A multivariate analysis revealed that PNI < 45, VATA/SMI ≥ 1.4 and FRS > 4 were the independent risk factors of CR-POPF. Conclusions Preoperative anthropomorphic imbalance, PNI, and FRS were independent risk factors for CR-POPF. Patients with high-risk factors should be closely monitored during the postoperative period. |
topic |
Fistula risk score Pancreaticoduodenectomy Postoperative pancreatic fistula Skeletal muscle index Visceral adipose tissue area |
url |
http://link.springer.com/article/10.1186/s12876-020-01397-7 |
work_keys_str_mv |
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